TY - JOUR
T1 - Sutureless Amniotic Membrane Transplantation for Partial Limbal Stem Cell Deficiency
AU - Kheirkhah, Ahmad
AU - Casas, Victoria
AU - Raju, Vadrevu K.
AU - Tseng, Scheffer C.G.
N1 - Funding Information:
This study was supported by a Joseph Swiger Fellowship from Ocular Surface Research and Education Foundation, Miami, Florida (Dr Kheirkhah). Dr Tseng and his family are more than 5% shareholders of TissueTech, Inc, which owns US patents 6,152,142 and 6,326,019 on the method of preparation and clinical uses of human amniotic membrane and ProKera distributed by Bio-Tissue, Inc. Involved in design of study (A.K., S.C.G.T.); data collection (A.K., V.C.); analysis and interpretation of the data (A.K., S.C.G.T.); preparation of manuscript (A.K.); and review and approval of the manuscript (V.K.R., S.C.G.T.). This study was approved by Institutional Review Board of Baptist Hospital of Miami/South Miami Hospital, Inc, Miami, Florida.
PY - 2008/5
Y1 - 2008/5
N2 - Purpose: To evaluate the results of sutureless amniotic membrane (AM) transplantation using fibrin glue for reconstructing corneal surfaces with partial limbal stem cell deficiency (LSCD). Design: Retrospective noncomparative interventional case series. Methods: Eleven eyes of nine patients that had LSCD with 120 degrees to almost 360 degrees of limbal involvement underwent superficial keratectomy to remove the conjunctivalized pannus followed by AM transplantation using fibrin glue. Additional sutureless AM patch (ProKera; Bio-Tissue, Inc, Miami, Florida, USA) was used in seven patients, and mitomycin C was applied on the cornea in four eyes and during fornix reconstruction in seven eyes. The surgery was repeated in three eyes for residual pannus. Results: During a mean follow-up of 14.2 ± 7.7 months (range, six to 26 months), all eyes maintained a smooth and stable corneal epithelial surface without recurrent erosion or persistent epithelial defect, and showed less stromal cloudiness and vascularization. Best-corrected visual acuity improved in nine eyes (81.8%). Corneal epithelialization proceeded by epithelial growth over AM (n = 4), accompanied by dissolution of AM (n = 4) or a combination of both (n = 3). No complication was noted regarding initial or repeated uses of fibrin glue. Conclusion: AM transplantation using fibrin glue appears to be a safe and effective method of restoring a stable corneal epithelium for cases with partial LSCD. This approach avoids the need of transplanting limbal epithelial stem cells.
AB - Purpose: To evaluate the results of sutureless amniotic membrane (AM) transplantation using fibrin glue for reconstructing corneal surfaces with partial limbal stem cell deficiency (LSCD). Design: Retrospective noncomparative interventional case series. Methods: Eleven eyes of nine patients that had LSCD with 120 degrees to almost 360 degrees of limbal involvement underwent superficial keratectomy to remove the conjunctivalized pannus followed by AM transplantation using fibrin glue. Additional sutureless AM patch (ProKera; Bio-Tissue, Inc, Miami, Florida, USA) was used in seven patients, and mitomycin C was applied on the cornea in four eyes and during fornix reconstruction in seven eyes. The surgery was repeated in three eyes for residual pannus. Results: During a mean follow-up of 14.2 ± 7.7 months (range, six to 26 months), all eyes maintained a smooth and stable corneal epithelial surface without recurrent erosion or persistent epithelial defect, and showed less stromal cloudiness and vascularization. Best-corrected visual acuity improved in nine eyes (81.8%). Corneal epithelialization proceeded by epithelial growth over AM (n = 4), accompanied by dissolution of AM (n = 4) or a combination of both (n = 3). No complication was noted regarding initial or repeated uses of fibrin glue. Conclusion: AM transplantation using fibrin glue appears to be a safe and effective method of restoring a stable corneal epithelium for cases with partial LSCD. This approach avoids the need of transplanting limbal epithelial stem cells.
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U2 - 10.1016/j.ajo.2008.01.009
DO - 10.1016/j.ajo.2008.01.009
M3 - Article
C2 - 18329626
AN - SCOPUS:43049139084
SN - 0002-9394
VL - 145
SP - 787
EP - 794
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 5
ER -