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

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