Simultaneous deep anterior lamellar keratoplasty and limbal allograft in bilateral limbal stem cell deficiency

Masahiro Omoto, Shigeto Shimmura, Shin Hatou, Yoshiyuki Ichihashi, Tetsuya Kawakita, Kazuo Tsubota

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Purpose: To report the efficacy of simultaneous keratolimbal allograft (KLAL) surgery and deep anterior lamellar keratoplasty (DALK) for limbal stem cell deficiency (LSCD). Methods: We conducted a retrospective, interventional case series of six consecutive eyes of five patients with LSCD and stromal opacity due to gelatinous drop-like dystrophy (two eyes), Stevens-Johnson syndrome (SJS, two eyes), or aniridia (two eyes). Only patients with normal lid anatomy and Schirmer test values greater than 3 mm were enrolled. DALK was performed by viscodissection followed by a thin, 360° KLAL designed by using an artificial anterior chamber. KLAL sutures were removed after 2 weeks. Results: DALK and KLAL were successfully performed in all eyes, which were followed for an average of 17.2 ± 10.8 months. All eyes recovered a smooth corneal epithelium, although one SJS patient developed a persistent epithelial defect (PED) leading to opacification of the central cornea. Visual acuity improved by more than 2 lines in all eyes except that of the SJS patient with PED. No other complications were observed. Conclusion: Simultaneous DALK and thin-section KLAL is an effective treatment for ocular surface disease in patients with residual tear function and normal lid anatomy.

Original languageEnglish
Pages (from-to)537-543
Number of pages7
JournalJapanese Journal of Ophthalmology
Volume54
Issue number6
DOIs
Publication statusPublished - 2010 Nov

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Corneal Transplantation
Allografts
Stem Cells
Anatomy
Aniridia
Stevens-Johnson Syndrome
Corneal Epithelium
Eye Diseases
Anterior Chamber
Tears
Cornea
Sutures
Visual Acuity

Keywords

  • deep anterior keratoplasty
  • keratolimbal allograft
  • limbal stem cell deficiency

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Simultaneous deep anterior lamellar keratoplasty and limbal allograft in bilateral limbal stem cell deficiency. / Omoto, Masahiro; Shimmura, Shigeto; Hatou, Shin; Ichihashi, Yoshiyuki; Kawakita, Tetsuya; Tsubota, Kazuo.

In: Japanese Journal of Ophthalmology, Vol. 54, No. 6, 11.2010, p. 537-543.

Research output: Contribution to journalArticle

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