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keratolimbal allograft

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https://www.readbyqxmd.com/read/28731936/case-series-keratolimbal-allograft-as-a-patch-graft-for-glaucoma-drainage-devices
#1
Sarah F Ahmed, Mason Schmutz, Sameh Mosaed
PURPOSE: Tube exposure remains one of the most common complications after glaucoma drainage device (GDD) implantation, despite various types of patch grafts available today. We present a 4 patient case series following the effectivity of the keratolimbal allograft (KLAL) as a patch graft for cases of tube exposure. Given its inherent population of stem cells, our hypothesis was that this highly replicative, biological tissue would provide an adequate means of glaucoma tube coverage. The subset of patients chosen for the KLAL patch graft all had a history of abnormally scarred conjunctiva or thin sclera...
July 20, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/28644241/long-term-ocular-surface-stability-in-conjunctival-limbal-autograft-donor-eyes
#2
Albert Y Cheung, Enrica Sarnicola, Edward J Holland
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...
June 21, 2017: Cornea
https://www.readbyqxmd.com/read/28614157/probable-donor-derived-cytomegalovirus-disease-after-keratolimbal-allograft-transplantation
#3
Albert Y Cheung, Amit Govil, Scott R Friedstrom, Edward J Holland
PURPOSE: To report a case of probable donor-derived cytomegalovirus (CMV) infection after keratolimbal allograft (KLAL) transplantation. METHODS: Observational case report. RESULTS: A 41-year-old man with a history of aniridic keratopathy and limbal stem cell deficiency underwent KLAL in his right eye. Preoperatively, he was negative for CMV IgG and IgM. Postoperatively, he was maintained on tacrolimus and mycophenolate mofetil for systemic immunosuppression; he was also on prophylactic valganciclovir (for CMV) and trimethoprim/sulfamethoxazole (for pneumocystis pneumonia) for 1 month...
August 2017: Cornea
https://www.readbyqxmd.com/read/28476053/transmission-of-donor-derived-breast-carcinoma-as-a-recurrent-mass-in-a-keratolimbal-allograft
#4
Audra K Miller, Jonathan W Young, David J Wilson, Jennifer Dunlap, Winston Chamberlain
PURPOSE: To report a case of local transmission of invasive lobular carcinoma from a donor to a recipient in a keratolimbal allograft after cessation of systemic immunosuppressive therapy. METHODS: This is a case report including the clinicopathologic findings. Sections of the donor breast tumor and recipient conjunctival lesions were stained with hematoxylin and eosin. Immunohistochemical studies were performed using pancytokeratin, CK7, CK20, CAM 5.2, CD138, TTF1, estrogen receptor, progesterone receptor, GATA-3, GCDFP-15, and mammaglobin...
June 2017: Cornea
https://www.readbyqxmd.com/read/28399069/conjunctival-limbal-autograft
#5
REVIEW
Sheraz M Daya
PURPOSE OF REVIEW: To provide an overview of conjunctival-limbal autografting (CLAU) for ocular surface rehabilitation with emphasis on more recent literature detailing outcomes of the procedure over the last 2 decades as well as technique variations and adjuvant techniques. RECENT FINDINGS: Limbal autografting initially described in 1964 by Barraquer and Strampelli and later popularized by Kenyon and Tseng is considered the best option for restoration of corneal phenotype in unilateral limbal stem-cell deficiency...
July 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28379858/keratolimbal-allograft
#6
REVIEW
Albert Y Cheung, Edward J Holland
PURPOSE OF REVIEW: Keratolimbal allograft (KLAL) transplants limbal tissue attached to a corneoscleral carrier from a cadaveric donor to deliver a large number of stem cells to the recipient. The present article will provide a review of KLAL focusing on the recent literature. RECENT FINDINGS: Recent findings pertain to tissue selection, immunosuppression and adverse event profiles, and postoperative complications (particularly related to immunologic rejection). SUMMARY: KLAL permits the treatment of limbal stem cell deficiency eyes when there is no available living-related or autograft tissue with minimal risk of irreversible toxicity from modern systemic immunosuppression...
July 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28025793/allogenic-cultivated-limbal-stem-cell-transplantation-versus-cadaveric-keratolimbal-allograft-in-ocular-surface-disorder-1-year-outcome
#7
Jitendra Kumar Singh Parihar, Avinash Singh Parihar, Vaibhav Kumar Jain, Jaya Kaushik, Pramod Nath
PURPOSE: To compare the outcome of allogenic ex vivo cultivated limbal stem cell transplantation (LSCT) versus cadaveric keratolimbal allograft in patients with limbal stem cell deficiency (LSCD). METHODS: In this prospective interventional study from Army Hospital Research and Referral in New Delhi, 50 eyes of 40 patients with ocular surface disorder having LSCD underwent either cultivated LSCT (group 1: 25 eyes of 20 patients) or keratolimbal allograft transplantation (group 2: 25 eyes of 20 patients)...
December 26, 2016: International Ophthalmology
https://www.readbyqxmd.com/read/27496499/changes-in-technique-and-indications-for-keratoplasty-in-poland-1989-to-2014-an-analysis-of-corneal-transplantations-performed-at-saint-barbara-hospital-trauma-center-sosnowiec-poland
#8
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
https://www.readbyqxmd.com/read/27467047/late-acute-rejection-after-allograft-limbal-stem-cell-transplantation-evidence-for-long-term-donor-survival
#9
MULTICENTER STUDY
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...
January 2017: Cornea
https://www.readbyqxmd.com/read/27413493/trends-in-indications-and-techniques-of-corneal-transplantation-in-iran-from-2006-to-2013-an-8-year-review
#10
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
https://www.readbyqxmd.com/read/27220223/ocular-surface-reconstruction-in-limbal-stem-cell-deficiency
#11
REVIEW
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
https://www.readbyqxmd.com/read/26655479/ocular-surface-squamous-neoplasia-in-a-living-related-conjunctival-limbal-allograft
#12
REVIEW
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
https://www.readbyqxmd.com/read/26299533/limbal-stem-cell-transplantation-for-soft-contact-lens-wear-related-limbal-stem-cell-deficiency
#13
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
https://www.readbyqxmd.com/read/26113596/intravenous-immunoglobulin-for-antibody-mediated-keratolimbal-allograft-rejection
#14
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...
June 25, 2015: BMJ Case Reports
https://www.readbyqxmd.com/read/25811723/ocular-surface-reconstruction-with-keratolimbal-allograft-for-the-treatment-of-severe-or-recurrent-symblepharon
#15
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
https://www.readbyqxmd.com/read/25709391/keratopathy-cataract-and-dry-eye-in-a-survey-of-aniridia-subjects
#16
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
https://www.readbyqxmd.com/read/25642642/long-term-management-of-severe-ocular-surface-injury-due-to-methamphetamine-production-accidents
#17
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
https://www.readbyqxmd.com/read/25289723/ocular-surface-reconstruction-by-cultivated-epithelial-sheet-transplantation
#18
REVIEW
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
https://www.readbyqxmd.com/read/25058380/live-related-versus-cadaveric-limbal-allograft-in-limbal-stem-cell-deficiency
#19
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/24138039/a-review-of-the-clinical-and-genetic-aspects-of-aniridia
#20
REVIEW
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
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