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Ophthalmology. 2003 Jan;110(1):125-30.

Management of aniridic keratopathy with keratolimbal allograft: a limbal stem cell transplantation technique.

Author information

  • 1Cincinnati Eye Institute, University of Cincinnati, Cincinnati, Ohio 45242, USA. eholland@fuse.net

Abstract

OBJECTIVE:

Aniridic keratopathy is a major cause of vision loss in patients with aniridia. Penetrating keratoplasty has been proven ineffective for the long-term treatment of this disorder because it does not address the stem cell deficiency that is the primary etiologic factor. We evaluated the role of keratolimbal allograft (KLAL), a stem cell transplantation technique, for the treatment of patients with aniridic keratopathy.

DESIGN:

Retrospective noncomparative interventional case series.

PARTICIPANTS:

Thirty-one eyes of 23 patients with aniridic keratopathy.

INTERVENTION:

KLAL.

MAIN OUTCOME MEASURES:

Ocular surface stability, visual acuity, and success of subsequent penetrating or lamellar keratoplasty.

RESULTS:

Thirty-one eyes of 23 patients were treated with KLAL and followed up for 12 to 117 months (mean, 35.7 months). Twenty-three eyes (74.2%) achieved a stable ocular surface. Overall, the mean visual acuity improved from 20/1000 to 20/165. Twenty eyes (64.5%) underwent subsequent penetrating keratoplasty. Fourteen corneal transplant grafts (70.0%) were successful, and six (30.0%) failed. Nineteen (90.5%) of 21 eyes receiving systemic immunosuppression obtained a stable ocular surface, whereas only 4 (40.0%) of 10 eyes not receiving systemic immunosuppression achieved ocular surface stability (P < 0.01).

CONCLUSIONS:

KLAL is effective in treating aniridic keratopathy. Patients receiving systemic immunosuppression have a greater likelihood of achieving ocular surface stability and improved visual acuity compared with those who receive only topical immunosuppression.

PMID:
12511357
[PubMed - indexed for MEDLINE]
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