PMID- 21092554
OWN - NLM
STAT- MEDLINE
DCOM- 20111202
LR  - 20101124
IS  - 0412-4081 (Print)
IS  - 0412-4081 (Linking)
VI  - 46
IP  - 9
DP  - 2010 Sep
TI  - [Limbal allografting from related live donors for limbal stem cell deficiency 
      secondary to ocular chemical burn].
PG  - 775-80
AB  - OBJECTIVE: To investigate the efficacy and complications of limbal allografting 
      from related live donors (RL-LAT) for limbal stem cell deficiency secondary to 
      ocular chemical burn. METHODS: Retrospective comparative case series. Limbal 
      allografting from related live human leukocyte antigen (HLA)-matched (n = 10) 
      and-unmatched donors (n = 2) was performed in 12 consecutive patients (12 eyes) 
      with limbal stem cell deficiency secondary to ocular chemical burn, including 9 
      alkali burn and 3 acid burn; whereas allolimbal cadaver transplant was performed 
      in another 15 patients in Zhongshan Ophthalmic Center between April 2006 to 
      December 2007. Systemic cyclosporine A was administered to later eight recipients 
      in living related donor group and all patients in cadaver donor group. Main 
      outcome measures were restoration of corneal epithelium, reduction in corneal 
      vascularization, improved corneal clarity, and visual improvement. Mean follow-up 
      was (11.4 +/- 3.6) months (from 12 to 27). RESULTS: In living related donor group, 
      ten patients (83.3%) achieved initially reepithelialize, and epithelial healing 
      time was (9.6 +/- 3.4) d. Nine patients (75.0%) achieved stable ocular surface 
      (stable corneal epithelium, decreased vascularization of corneal surface, and 
      reduced corneal opacification). However, in seven eyes (77.8%) achieved stable 
      ocular surface, gradual recurrence of peripheral corneal vascularization occurred 
      after 5 to 8 months postoperatively. Whereas in cadaver donor group, twelve 
      patients (80.0%) achieved initially reepithelialize, and epithelial healing time 
      was (11.2 +/- 4.6) d. Seven patients (46.7%) achieved stable ocular surface. 
      However, in all seven eyes achieved stable ocular surface, gradual recurrence of 
      peripheral corneal vascularization occurred after 4 to 10 months postoperatively. 
      The differences of both the rate of initially reepithelialize and epithelial 
      healing time between these two groups showed no statistical significance (chi(2) = 
      1.764, P = 0.117; t = 0.116, P = 0.133, respectively). However, the differences 
      of both the successful rate of ocular surface reconstruction and the recurrent 
      rate of corneal vascularization during the follow-up period between these two 
      groups were statistically significant (chi(2) = 4.158, P = 0.015; chi(2) = 3.463, P = 
      0.022, respectively). In living related donor group, features of graft rejection 
      developed in two patients with postoperative stable ocular surface, Both rejected 
      recipients had one among HLA-matched and one among-unmatched respectively. 
      Whereas in cadaver donor group, features of graft rejection developed in three 
      patients with postoperative stable ocular surface. None of the donor eyes had any 
      complications. CONCLUSIONS: Limbal allografting from related live donors is more 
      effective to reconstruct the ocular surface of limbal stem cell deficiency 
      secondary to ocular chemical burn than allolimbal cadaver transplant. HLA-matched 
      limbal allografting could reduce postoperative graft rejection and systemic 
      cyclosporine A is useful in ensuring long-term survival.
FAU - Huang, Ting
AU  - Huang T
AD  - State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen 
      University, Guangzhou 510060, China. thuang@vip.163.com
FAU - Yang, Shi-qing
AU  - Yang SQ
FAU - Gao, Na
AU  - Gao N
FAU - Wang, Yu-juan
AU  - Wang YJ
LA  - chi
PT  - English Abstract
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Zhonghua Yan Ke Za Zhi
JT  - [Zhonghua yan ke za zhi] Chinese journal of ophthalmology
JID - 16210540R
SB  - IM
MH  - Adolescent
MH  - Burns, Chemical/surgery
MH  - Child
MH  - Corneal Diseases/etiology/*surgery
MH  - *Corneal Transplantation
MH  - Eye Burns/surgery
MH  - Female
MH  - Graft Survival
MH  - Humans
MH  - Limbus Corneae/cytology
MH  - *Living Donors
MH  - Male
MH  - Retrospective Studies
MH  - Stem Cell Transplantation
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2010/11/26 06:00
MHDA- 2011/12/13 00:00
CRDT- 2010/11/25 06:00
PHST- 2010/11/25 06:00 [entrez]
PHST- 2010/11/26 06:00 [pubmed]
PHST- 2011/12/13 00:00 [medline]
PST - ppublish
SO  - Zhonghua Yan Ke Za Zhi. 2010 Sep;46(9):775-80.