Limbal autograft for reconstruction of the ocular surface in patients withunilateral limbal stem cell deficiency

Purpose: To evaluate the improvement of the ocular surface after limbal aut ograft in patients with unilateral limbal stem cell deficiency related to c hemical burns. Materials and methods : Limbal autograft was performed in five patients wit h unilateral limbal stem cell deficiency related to chemical burns. Thereaf ter four patients underwent penetrating keratoplasty. The limbal graft was obtained from the fellow eye, and was secured with interrupted sutures. Pat ient follow-up ranged from 10 to 47 months. Limbus and corneas were studied by means of light microscopy. Results: All five patients reported subjective improvement. Vascularization decreased in one cornea. Visual acuity improved in one eye and did not cha nge in the remaining four eyes. After penetrating keratoplasty, graft reepi thelialization was achieved after respectively 3, 4, 21, and 30 days. Light microscopy showed the presence of goblet cells in the limbal epithelium in four cases. After limbal autograft, the corneal epithelium was devoid of g oblet cells in three out of four cases. Conclusion : Limbal autograft improves the ocular surface and the prognosis of subsequent penetrating keratoplasty in patients with unilateral limbal stem cell deficiency related to chemical burn.