A CLINICAL STUDY OF LIMBAL STEM CELL TRANSPLANTATION IN VARIOUS OCULAR SURFACE DISORDERS

AIMS: The purpose of this study is to evaluate the various causes of limbal stem cell deficiency, to assess signs and symptoms in ocular surface disorder and improvement following stem cell transplantation, to carry out limbal stem cell transplantation in various ocular surface disorders and to assess various intraoperative and postoperative complications following stem cell transplantation. METHODS: This study included 40 cases of ocular surface disorders treated with limbal autograft transplantation. Patients were recorded in a predesigned proforma, including the detailed history and complete ophthalmological examination. All cases of ocular surface disorders were treated with conjunctivo-limbal autograft transplantation under peribulbar and facial anaesthesia. RESULT: Maximum number of patients belong to age group 30-40 years. Males were more commonly affected by ocular surface disorders than females. (1.8:1). various causes of limbal stem cell deficiency were reviewed. The most common etiology associated with limbal stem cell deficiency was pterygia (60%) followed by vascularised leucomatous corneal opacity (20%), chemical burns (15%) and epitheliopathy (5%). Most common symptoms reported by patients were redness (100%), foreign body sensation (90%), watering (85%) and photophobia (50%). Most common signs found were conjunctival congestion (90%), corneal vascularization (70%), conjunctivalisation (70%) and epithelial defects (30%). 72.5% of patients reported increased ocular comfort. Postoperative incidence of redness was reduced from 90% to 20%, watering from 85% to 15% and photophobia from 50% to 25%. Improvement in signs was noted as decrease in conjunctival congestion from 90% to 22.2%, vascularisation from 70% to 35%, conjunctivalisation from 70% to 21.5% and epithelial defects from 30% to 16.6%. CONCLUSIONS: Use of autologous limbal transplantation with corneal and conjunctival tissue as a vehicle was useful for ocular surface reconstruction in patients with stem cell deficiency.