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Amniotic membrane transplantation with or without autologous cultivated limbal stem cell transplantation for the management of partial limbal stem cell deficiency

Authors Sharma N, Mohanty S, Jhanji V, Vajpayee RB

Received 21 July 2018

Accepted for publication 11 September 2018

Published 17 October 2018 Volume 2018:12 Pages 2103—2106


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Scott Fraser

Namrata Sharma,1 Sujata Mohanty,2 Vishal Jhanji,3,4 Rasik B Vajpayee4–6

1Cornea, Cataract and Refractive Surgery Services, Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India; 2Stem Cell Facility DBT – Centre of Excellence for Stem Cell Research, All India Institute of Medical Sciences, New Delhi, India; 3Cornea, Cataract and External Disease Services, Refractive Surgery Service, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; 4Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; 5Royal Victorian Eye and Ear Hospital, Melbourne, Australia; 6Cornea, Cataract & Refractive Surgery Services, Vision Eye Institute, Melbourne, Australia

Purpose: To compare the outcomes of amniotic membrane transplantation (AMT) vs cultivated limbal stem cell transplantation (LSCT) in eyes with partial limbal stem cell deficiency (LSCD) following chemical burns.
Methods: Eyes with unilateral partial LSCD (≤180° involvement) were randomized in two groups to undergo either pannus resection combined with AMT or pannus resection combined with LSCT in a tertiary eye care hospital. Primary outcome measures were time to corneal epithelialization and absence of conjunctivalization of the cornea. Patients were followed up at 1 week, 1, 3, 6, and 12 months after the surgical procedure.
Results: There was no difference between mean age (30.85±5.8 vs 28.64±6.4 years, P=0.40) and sex distribution of patients between the two groups at baseline. Mean time to corneal epithelialization was 10.45±5.8 days in the AMT group and 11±3.9 days in the LSCT group (P=0.43). At the end of 1 year, there was no significant difference between the degree of conjunctivalization of cornea, (P=0.06) corneal vascularization, (P=0.08), and clarity (P=0.07) in both groups.
Conclusion: Our study showed that AMT alone is a useful therapeutic modality in cases with partial LSCD due to ocular chemical injury. Stem cell transplantation may not be required in these cases.

Keywords: partial LSCD, amniotic membrane transplantation, limbal stem cell transplantation

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