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Autologous transplantation of conjunctiva by modifying simple limbal epithelial transplantation for limbal stem cell deficiency

  • Tohru Sakimoto
  • Akira Sakimoto
  • Satoru YamagamiEmail author
Clinical Investigation
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Abstract

Purpose

As a treatment to replace regenerative medicine to treat limbal stem cell deficiency (LSCD), we performed 4 consecutive cases of autologous transplantation of conjunctival explants by modifying simple limbal epithelial transplantation (SLET).

Study design

Single-center case series.

Methods

Four patients with LSCD were enrolled in this study. After resection of scar tissue with neovascularization from the ocular surface, human amniotic membrane (AM) was placed over the bare ocular surface. The bulbar conjunctiva of the operated eye was dissected at the temporal superior fornix, divided into small pieces, and transplanted onto AM with fibrin glue. Keratoplasty was performed simultaneously or few months after surgery.

Results

Epithelialization was achieved in all patients. Best-corrected visual acuity was improved in all patients.

Conclusion

This is the first report of ocular surface reconstruction using autologous conjunctival epithelial transplants from the affected eye. Transplantation by modifying SLET effectively restored a clear corneal surface with minimal neovascularization in 4 patients with LSCD. Autologous conjunctival transplants combined with AM transplantation could be a practical option for treating bilateral LSCD in patients without symblepharon or severe keratinization.

Keywords

Conjunctival transplantation Limbal stem cell deficiency Simple limbal epithelial transplantation 

Notes

Acknowledgements

The authors indicate no funding support.

Conflicts of interest

T Sakimoto, None; A. Sakimoto, None; S. Yamagami, None.

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Copyright information

© Japanese Ophthalmological Society 2019

Authors and Affiliations

  • Tohru Sakimoto
    • 1
  • Akira Sakimoto
    • 1
  • Satoru Yamagami
    • 1
    Email author
  1. 1.Division of Ophthalmology, Department of Visual SciencesNihon University School of MedicineTokyoJapan

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