urvival Analyi of Conjunctival Limbal Graft and Amniotic Membrane Tranplantation in Eye With Total Limbal tem Cell Deficiency

Purpoe To evaluate the urvival of conjunctival limbal graft and amniotic membrane tranplantation (AMT) for total limbal tem cell deficiency (LCD) and the influence of everal parameter a caue of LCD, dry eye, keratinization, eyelid abnormalitie, HLA compatibility, ytemic immunouppreion, and keratoplaty (PKP) on urgical outcome. Deign Propective, noncomparative, interventional cae erie. Method Thirty-three eye of 31 patient with total LCD that underwent conjunctival limbal graft and AMT at the Department of Ophthalmology, Federal Univerity of ão Paulo were included in thi tudy. Cumulative graft urvival a well a the influence of everal variable on urgical outcome wa analyzed. Reult Ten eye (30%) underwent conjunctival limbal autograft and 23 (70%) underwent conjunctival limbal allograft from living HLA-matched donor. Graft urvival wa een in 13 eye (40%) at 1 year and in 11 eye (33.3%) at 2 year, with a cumulative urvival of 33% after a mean follow-up time of 33 month. Increae in potoperative viual acuity wa oberved in 20 eye (60.6%) during thi period. Marked impact on graft urvival wa oberved for patient with teven-Johnon yndrome, dry eye, keratinization, eyelid abnormalitie, and allogeneic conjunctival limbal tranplantation (independently of HLA compatibility) (P < .05). Preoperative dry eye wa the mot important prognotic parameter for urgical outcome (P < .001). Concluion Conjunctival limbal graft aociated with AMT are ueful for retoring corneal epithelium phenotype in eye with total LCD. However, the cumulative urvival decline ubtantially over a 2-year period. Conidering all invetigated variable, dry eye wa the mot important prognotic parameter.