Long-Term Ocular Surface Stability in Conjunctival Limbal Autograft Donor Eyes

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To investigate the incidence of limbal stem cell deficiency (LSCD) in donor eyes after conjunctival limbal autograft (CLAU).


An observational retrospective review was performed on all patients who underwent CLAU alone, combined keratolimbal allograft with CLAU (“Modified Cincinnati Procedure”), or combined living-related conjunctival limbal allograft (lr-CLAL) with CLAU having ≥6 months of follow-up after surgery. The outcome measures were best-corrected visual acuity (BCVA) and ocular surface status.


The inclusion criteria were fulfilled by 45 patients. Of these, 26 patients underwent CLAU, 18 underwent combined keratolimbal allograft/CLAU, and 1 underwent combined lr-CLAL/CLAU. Mean age at the time of surgery was 39.6 years. Mean logMAR preoperative BCVA was −0.08. There were no operative complications. The mean follow-up duration after surgery was 48.3 months (range 8.3–181.5 mo). At last follow-up, all eyes maintained a stable ocular surface, and mean logMAR BCVA was −0.05.


With the advent of newer ocular surface transplantation methods, there has been concern that CLAU carries the theoretical risk of inducing LSCD. Our long-term clinical results following donor eyes after CLAU demonstrate no signs of LSCD.

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