Early Results of Penetrating Keratoplasty in Patients With Unilateral Chemical Injury After Simple Limbal Epithelial Transplantation.

PURPOSE

To evaluate clinical outcomes of sequential PKP in eyes with unilateral chemical injury, which have previously undergone autologous simple limbal epithelial transplantation (SLET) at a tertiary eye center in North India.

METHODS

This is a single-center, retrospective, noncomparative interventional case series reviewing patients with unilateral limbal stem cell deficiency treated by SLET and sequential PKP between 2012 and 2017. The primary outcome was defined as allograft survival, defined as a completely epithelialized, clear, avascular graft. The secondary outcome was improvement in best-corrected visual acuity by 2 lines or any complications.

RESULTS

Seven eyes of 7 patients, all aged below 40 years, who underwent SLET followed by PKP for unilateral ocular surface injury were included. Most of the patients were male (71.4%), and alkali injury (42.8%) was the most common cause of limbal stem cell deficiency. The mean duration between SLET and PK was 9.5 ± 11.9 months (2-36 mo), and the mean follow-up duration after PKP was 15.1 ± 5.4 months (6-21 mo). A successful outcome after SLET was achieved in all 7 patients and clear grafts in 6 patients, with a graft survival rate of 85% at 6 months. Visual success was noted in 4 patients. Poor vision in 3 patients was due to glaucoma, amblyopia, and graft failure.

CONCLUSIONS

PKP was found to have a good outcome when the surface has been stabilized by SLET as an initial procedure in unilateral ocular chemical injury. The visual outcome was restricted mainly by other causes such as glaucoma and amblyopia.