Comparative analysis of long-term results of three epithelial cell transplantation procedures for treating limbal stem cell deficiency
1
Issued Date
2024-04-01
Resource Type
ISSN
15420124
eISSN
19375913
Scopus ID
2-s2.0-85183151001
Pubmed ID
38224776
Journal Title
Ocular Surface
Volume
32
Start Page
71
End Page
80
Rights Holder(s)
SCOPUS
Bibliographic Citation
Ocular Surface Vol.32 (2024) , 71-80
Suggested Citation
Kengpunpanich S., Chirapapaisan C., Ngowyutagon P., Chotikavanich S., Sikarinkul R., Taetrongchit N., Setthawong S., Prabhasawat P. Comparative analysis of long-term results of three epithelial cell transplantation procedures for treating limbal stem cell deficiency. Ocular Surface Vol.32 (2024) , 71-80. 80. doi:10.1016/j.jtos.2024.01.003 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/95816
Title
Comparative analysis of long-term results of three epithelial cell transplantation procedures for treating limbal stem cell deficiency
Author's Affiliation
Corresponding Author(s)
Other Contributor(s)
Abstract
This study compared the long-term outcome of different epithelial transplantation techniques to treat limbal stem cell deficiency (LSCD). We conducted a retrospective 15-year comparative systematic cohort study of patients with LSCD who underwent either cultivated limbal epithelial transplantation (CLET), simple limbal epithelial transplantation (SLET), or cultivated oral mucosal epithelial transplantation (COMET). We reviewed the demographic data, etiology, LSCD severity, best-corrected visual acuity, surgical outcomes, and complications. A total of 103 eyes of 94 patients (mean age, 45.0 ± 16.4 years) with LSCD were enrolled. The most common cause of LSCD was chemical injury (42.7 %). The median follow-up time was 75 months. The success rates of CLET, SLET, and COMET were 45.5 %, 77.8 %, and 57.8 %, respectively. The 7-year survival rates after CLET, SLET, and COMET were 50.0 %, 72.2 %, and 53.2 %, respectively. Steven-Johnson syndrome (SJS) had a significantly lower survival rate than other causes (p < 0.001), but SLET had a significantly higher survival rate than CLET (p = 0.018) and COMET (p = 0.047). Visual improvement of more than four Snellen lines was achieved in 53.1 % of successful cases and 28.2 % of failed cases. SJS, Schirmer I test <5 mm, and the presence of postoperative recurrent epithelial defects were significant risk factors for a failed surgery. All epithelial transplantation techniques had favorable long-term surgical outcomes. More than half of the patients achieved a stable ocular surface and visual acuity improvement up to 7 years postoperatively. SLET tends to have a better surgical outcome than CLET and COMET, especially in patients with SJS.