Transplantation of circumferentially-trephined autologous oral mucosal graft on ocular surface reconstruction in patients with limbal stem cell deficiency

Session Details

Session Title: Presented Poster Session: Cornea: Surgical

Venue: Poster Village: Pod 3

First Author: : H.Choe SOUTH KOREA

Co Author(s): :    C. Yoon   M. Kim                    

Abstract Details

Purpose:

To investigate effect of transplantation of circumferentially-trephined autologous oral mucosal graft using vaccum-trephine on ocular surface reconstruction in patients with limbal stem cell deficiency

Setting:

The patients with limbal stem cell deficiency who underwent transplantation of autologous oral mucosal graft by one surgeon (MK Kim) in Seoul National University Hospital were included. The medical records of the 5 patients were retrospectively reviewed

Methods:

Lower labial mucosal graft inside the inferior lip was trephined in 250 um depth using donor vacuum trephine (Hessburg–Barron trephine; Katena Products, Denville, NJ, USA) of 9 mm diameter. Outside marking was made using 14 mm intraoperative keratometer (K3-7888; Katena, Denville, NJ, USA). Oral mucosal graft was dissected using a Beaver mini-blade (Beaver-Visitec International, Waltham, MA, USA) as ring or crescent-shaped strip of 5 mm width. Ring or crescent-shaped mucosal graft was transplanted onto limbus in total or partial limbal deficient eyes. Best corrected visual acuity, corneal status (staining score, neovascularization and corneal opacity) were measured during follow-up.

Results:

Four patients were diagnosed as Stevens-Johnson syndrome and one as atopy associated immune keratitis. Mean of follow-up period was 10.4±2.9 months. After 4 months, visual acuity was improved in all patients and mean improvement of logMAR visual acuity was 0.526±0.470 (0.15~1.10). Corneal surface erosion and neovascularization decreased in 4 patients and stromal opacity decreased in 2 patients. Finally, the engraftments were maintained stabilizing ocular surface in 4 of 5 patients at last follow-up.

Conclusions:

Transplantation of circumferential-shaped autologous oral mucosal graft may be effective for the treatment of limbal stem cell deficiency.

Financial Disclosure:

None