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keratolimbal allograft

J Jankowska-Szmul, D Dobrowolski, K Krysik, J Kwas, M Nejman, E Wylegala
BACKGROUND: The purpose of this work was to study the evolving trends in techniques and indications for corneal transplantation in Poland. METHODS: This retrospective, descriptive analysis of corneal transplantations was performed at the Ophthalmology Department of Saint Barbara Hospital, Trauma Center, Sosnowiec, Poland, between 1988 and 2014. Structure of indications and surgery type rates over 26 years were tabulated by means of 5-year intervals. RESULTS: Between 1989 and 2014, 1762 corneal transplantations were performed, including 1375 (78%) cases of penetrating keratoplasty, 137 (8%) lamellar keratoplasty, 112 (6%) patch grafts, and 138 (8%) keratolimbal allografts...
June 2016: Transplantation Proceedings
Medi Eslani, Zeeshan Haq, Asadolah Movahedan, Adam Moss, Alireza Baradaran-Rafii, Gautham Mogilishetty, Edward J Holland, Ali R Djalilian
PURPOSE: To describe the clinical presentation and management of late (>3.0 years) acute graft rejection in keratolimbal allograft (KLAL) recipients. METHODS: This was a multicenter, retrospective observational case series. Six eyes of 6 patients with ocular surface transplant at a mean age of 36.2 years were seen at 3 tertiary referral centers for acute graft rejection between 2007 and 2013. Main outcome measures included strength of systemic immunosuppression (SI) at the time of rejection, time to rejection, and clinical presentation of rejection...
July 27, 2016: Cornea
Mozhgan Rezaei Kanavi, Mohammad Ali Javadi, Tahmineh Motevasseli, Tahereh Chamani, Mahnoush Rezaei Kanavi, Bahareh Kheiri, Sare Safi
PURPOSE: To report changing trends in indications and techniques of corneal transplantation in Iran. METHODS: We reviewed eye bank records of 47,129 patients who had undergone corneal transplantation between 2006 and 2013 at different eye centers throughout Iran. RESULTS: The most common indication for corneal transplantation was keratoconus (KCN, n = 21,350 eyes, 45.3%), followed by bullous keratopathy (BK, n = 8,566 eyes, 18.2%), corneal opacity and scar (COS, n = 7,158 eyes, 15...
April 2016: Journal of Ophthalmic & Vision Research
Alina Gheorghe, Monica Pop, Fildis Mrini, Ramona Barac, Iulia Vargau
The purpose of our review was to familiarize the readers with the new concepts in ocular surface diseases and reconstruction. Limbal stem cell deficiency is characterized by the progressive invasion of conjunctival epithelial cells onto the cornea, superficial vascularisation, destruction of the corneal basement membrane, and chronic inflammatory cell infiltration. Depending on the severity of the disease and the time passed from the primary injury amniotic membrane transplantation, keratolimbal allograft and autograft are the available treatments hoping that, in the nearest future, stem cell transplantation and tissue engineering will become the usual therapeutic choices...
January 2016: Romanian Journal of Ophthalmology
Kevin J Shah, Gautham Mogilishetty, Edward J Holland
PURPOSE: To report a single case of ocular surface squamous neoplasia (OSSN) that occurred in a living-related conjunctival limbal allograft (lr-CLAL). METHODS: Case report and literature review. RESULTS: A 70-year-old white man developed OSSN in a histocompatible identical lr-CLAL over 3 years after the surgical procedure. Incisional biopsy was performed, and topical interferon alpha-2b was initiated. Pathology results confirmed carcinoma in situ...
February 2016: Cornea
Carl Shen, Clara C Chan, Edward J Holland
PURPOSE: To describe the outcomes of limbal stem cell transplantation in eyes with limbal stem cell deficiency related to soft contact lens wear. DESIGN: Retrospective interventional case series. METHODS: Institutional database search at the Cincinnati Eye Institute revealed 9 patients (14 eyes) who underwent limbal stem cell transplantation with systemic immunosuppression for soft contact lens wear-related limbal stem cell deficiency. Outcome measures included patient demographics, symptoms, best-corrected visual acuity, ocular surface stability, adverse events, and additional surgeries required...
December 2015: American Journal of Ophthalmology
Victoria Squissato, Jeffrey Schiff, Clara C Chan
A 33-year-old woman with congenital aniridia presented with decreased vision in her right eye. Slit lamp examination revealed diffuse conjunctivalisation of the ocular surface with mild subepithelial fibrosis consistent with aniridic keratopathy secondary to limbal stem cell deficiency. She underwent limbal stem cell transplantation with cadaver donor tissue (keratolimbal allograft (KLAL) surgery) and received systemic immunosuppression. Despite optimal combination immunosuppressive therapy managed by a renal transplant specialist, 2 weeks after the KLAL, the patient developed intractable eye pain, conjunctival injection, dilation of the KLAL graft blood vessels and limbal haemorrhages...
2015: BMJ Case Reports
Marjan Farid, Nancy Lee
PURPOSE: To describe an ocular surface reconstruction technique using keratolimbal allograft (KLAL) tissue to repair and treat severe or recurrent symblepharon. METHODS: Five eyes of 5 patients (age 23-71 years) with severe or recurrent symblepharon causing symptomatic restrictive diplopia in primary gaze have been treated. After meticulous symblepharon lysis and scar tissue removal, KLAL tissue was sutured onto the ocular surface and used as a spacer to prevent recurrent scar formation...
June 2015: Cornea
David Shiple, Brenton Finklea, James D Lauderdale, Peter A Netland
PURPOSE: To determine the prevalence of keratopathy, cataract, and dry eye in a group of individuals with aniridia. METHODS: We reviewed survey data from the Aniridia Foundation International (AFI) registry, which included 99 subjects who self-reported on corneal disease, cataract, and dry eye disease. RESULTS: The average age of respondents was 25.3±18.6 years, with a range of 0 to 67. Of 99 subjects, 46% stated they have corneal disease, 32% stated they did not, and 22% were unsure...
2015: Clinical Ophthalmology
Asadolah Movahedan, Brad M Genereux, Mahshad Darvish-Zargar, Kevin J Shah, Edward J Holland
PURPOSE: The aim of this study was to report the clinical features and management of patients with ocular surface damage during methamphetamine production accidents. METHODS: This is a retrospective noncomparative interventional case series of 5 patients with methamphetamine production-related ocular injuries referred to the Cincinnati Eye Institute between 1999 and 2014. RESULTS: Four of 5 cases were white young men with severe bilateral ocular injury and extremely poor vision...
April 2015: Cornea
Yoshiyuki Satake, Takefumi Yamaguchi, Masatoshi Hirayama, Kazunari Higa, Seika Shimazaki-Den, Murat Dogru, Tetsuya Kawakita, Motoko Kawashima, Shigeto Shimmura, Kazuo Tsubota, Jun Shimazaki
Recent advances in ocular surface reconstruction for patients with severe ocular surface diseases have significantly improved the prognosis of patients with vision-impairing corneal abnormalities. The history of cultivated epithelial sheet transplantation is short, and debate on the current approaches for these procedures is continuing. Limbal stem cell transplantation, including conjunctivolimbal autograft and keratolimbal allograft, has brought opportunities for vision improvement. In addition, the use of cultivated limbal epithelial transplantation from both allogeneic and autologous sources has provided further options for immediate postoperative epithelialization of the corneal surface...
November 2014: Cornea
Jeewan S Titiyal, Namrata Sharma, Ashish K Agarwal, Gaurav Prakash, Radhika Tandon, Rasik Vajpayee
AIM: To compare outcomes of live related limbal allograft (Lr-CLAL) versus cadaveric keratolimbal allograft (KLAL) in limbal stem cell deficiency (LSCD) secondary to ocular burns. METHODS: Twenty patients with stage IIb LSCD were randomized so that cases underwent either Lr-CLAL or KLAL. Fibrovascular pannus was removed and superficial keratectomy done on the recipient bed. Limbal lenticule of 2-3 clock hours' length was harvested from the donor, which was placed over the host bed and sutured followed by bandage contact lens application...
June 2015: Ocular Immunology and Inflammation
Hyunjoo J Lee, Kathryn A Colby
Aniridia classically presents with a bilateral congenital absence or malformation of the irides, foveal hypoplasia, and nystagmus, and patients tend to develop visually significant pre-senile cataracts and keratopathy. Additionally, they are at high risk for developing glaucoma. Classic aniridia can be genetically defined as the presence of a PAX6 gene deletion or loss-of-function mutation that results in haploinsufficiency. Variants of aniridia, which include a condition previously referred to as autosomal dominant keratitis, are likely due to PAX6 mutations that lead to partial loss of PAX6 function...
September 2013: Seminars in Ophthalmology
Ayse Burcu, Zuleyha Yalniz-Akkaya, Muhammet Fatih Ozdemir, Elif Erdem, Mehmet Mustafa Onat, Firdevs Ornek
PURPOSE: The purpose of this study is to evaluate the management of limbal stem cell deficiency (LSCD) secondary to chemical ocular burns. MATERIALS AND METHODS: The charts of 48 eyes of 40 patients with grade 2 or higher chemical injury were evaluated retrospectively. Subjects with follow-up longer than 1 year were included. Medical treatment, surgical correction of abnormalities of ocular adnexial structures, limbal stem cell transplantation from patient's fellow eye, from living relatives or from cadaveric donor, amniotic membrane transplantation, conjunctival epitheliectomy, chelation with ethylenediaminetetraacetic acid and penetrating keratoplasty were the treatment modalities...
March 2014: Cutaneous and Ocular Toxicology
Cheng Li, Nuo Dong, Huping Wu, Fei Dong, Yajie Xu, Huiyi Du, Hui He, Zuguo Liu, Wei Li
PURPOSE: We investigated the efficacy of low-temperature airlift preservation of human corneal limbal tissue for ex vivo expansion and allograft keratolimbal transplantation. METHODS: Human limbal tissue either was submerged or airlifted in Optisol-GS medium and preserved at 4°C for up to eight days. Hematoxylin and eosin, and E-cadherin staining was performed to investigate epithelial structure and cell-cell junction. Epithelial cell differentiation and proliferation were studied using the biomarkers, such as K10, K12, K14, Ki67, and p63...
June 2013: Investigative Ophthalmology & Visual Science
Alireza Baradaran-Rafii, Medi Eslani, Ali R Djalillian
PURPOSE: To report postoperative complications of keratolimbal allograft (KLAL) transplantation in patients with bilateral total limbal stem cell deficiency. METHODS: In this retrospective observational case series, medical charts of 45 patients with at least 6 months of follow-up were reviewed. The main outcome measure was postoperative complications including graft-related issues (thickness, position, and alignment) and immunologic rejection. RESULTS: Sixty-six KLALs were performed on 45 eyes...
May 2013: Cornea
Sepehr Feizi, Mohammad A Javadi, Mohammad R Jafarinasab, Farid Karimian
PURPOSE: To compare the outcomes of penetrating keratoplasty (PK) and lamellar keratoplasty (LK) in patients with mustard gas keratitis. METHODS: A total of 78 eyes of 55 patients with mustard gas keratitis were included. Of these eyes, 27 (34.6%) underwent PK and 51 (63.4%) received LK. Keratolimbal allografts were performed in 11 and 30 eyes of the PK and LK groups, respectively. The study groups were compared in terms of best spectacle-corrected visual acuity, refractive error, and keratometry readings...
April 2013: Cornea
Andrea Y Ang, Clara C Chan, Joseph M Biber, Edward J Holland
PURPOSE: To describe the incidence, characteristics, risk factors, treatment, and outcomes of ocular surface stem cell transplantation (OSST) rejection. METHODS: A chart review of patients who had OSST at a single institution between 1998 and 2010 was performed. Data were collected on patient demographics, type of OSST procedure, duration of immunosuppression, and rejection characteristics. Main outcome measures were ocular surface stability and improvement in best-corrected visual acuity...
March 2013: Cornea
Geetha Iyer, Bhaskar Srinivasan, Shweta Agarwal, Ravi Barbhaya
PURPOSE: To analyze the outcome (functional and anatomic) of eyes that underwent tenonplasty as the primary globe-saving procedure in severe ocular chemical injuries (grade V-VI Dua's classification). METHODS: The records of patients who underwent tenonplasty for associated scleral ischemia in severe chemical burns in our institute between October 2005 and June 2011 were analyzed retrospectively. Out of 31 eyes that underwent tenonplasty, 21 belonged to grade V and VI of Dua's classification with diffuse scleral ischemia for which a four-quadrant tenonplasty was performed and only these 21 eyes were included for further analysis...
December 2012: Graefe's Archive for Clinical and Experimental Ophthalmology
M Krakauer, J D Welder, H K Pandya, N Nassiri, A R Djalilian
Purpose. Keratolimbal allograft (KLAL) is a treatment for limbal stem cell deficiency. One disadvantage is systemic immunosuppression to avoid rejection. Our purpose was to examine the adverse effects of systemic immunosuppression in KLAL. Methods. A retrospective case review of 16 patients with KLAL who received systemic immunosuppression consisting of a corticosteroid, an antimetabolite, and/or a calcineurin inhibitor was performed. Patients were monitored for signs, symptoms, or laboratory evidence of toxicity...
2012: Journal of Ophthalmology
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