Treatment of Severe Caustic Damage of the Anterior Segment of the Eye byTransplantation of Limbal Stem Cells, Perforating Keratoplasty and Transplantation of the Amniotic Membrane

Overview

The concept of limbal stem cells (LSC) opened new possibilities for the treatmentof severe caustic damage of the anterior segment. These possibilities includetransplantation of LSC, perforating keratoplasty, possibly transplantation of theamniotic membrane. In three patients with severe caustic damage of the anterior segment of the eye the authors implemented transplantation of LSC, perforatingkeratoplasty and in one patient also transplantation of the amniotic membrane.Where only one eye was damaged LSC for transplantation were obtained from thesound eye (autotransplantation, in case of damage of both eyes LSC were obtainedin one case from a close relative in the second case from a cadaverous eye froma corneal bank (Allotransplantation). In the patient with autotransplantation ofLSC, perforating keratoplasty and transplantation of the amniotic membrane theresult was very good. The corneal disc remained clear 1.5 years after operation,the conjunctival sac was free from synbleropharons and vision improved frommoveent of the hand to 0.5. In the two patients with allotransplantation of LCSand perforating keratoplasty, LCS did not become incorporated despite immunosuppressive treatment and the corneal disc became turbid. Restored activity of LCS in severe caustic damage of the anterior segment opened new therapeuticopportunities.

Key words:
caustic damage of the eye, limbal stemcells, perforating keratoplasty,amniotic membrane