Long-term Outcome of Limbal Stem Cell Transplantation for Management of Total Limbal Stem Cell Deficiency due to Chemical Burn

Purpose: To evaluate the long-term outcome of limbal stem cell transplantation for management of total limbal stem cell deficiency due to chemical burn. Patients and Methods: In this retrospective cross sectional study; records of patients with history of severe (grade III to IV) chemical burns who underwent limbal stem cell transplantation in Labbafinejad Medical Center, Tehran, Iran between 2006 and 2016 were reviewed and data including demographic characteristics, visual acuity, surgical interventions and outcomes were reported. Results: Fifty eyes of fifty patients with a history of conjunctival limbal autograft (N = 24) or keratolimbal allograft (N = 26) with at least 12-months follow-up were included. The overall 1-year and 5-year survival were 100 % and 84.1 % for conjunctival limbal autograft and 80.4 % and 40 % for keratolimbal allograft, respectively (P = 0.037). The 1-year and 5-year corneal graft survival were 93.3 % and 63.8 % after conjunctival limbal autograft and 92 % and 38.4 % after kera-tolimbal allograft (P = 0.005 for five year survival). There was a signif-icant improvement in LogMAR BCVA (1.79 versus 2.17, P < 0.001) in all patients with no statistically significant difference between the two groups. Conclusion: Severe chemical burn is associated with significant ocular morbidity and long-term prognosis is poor. Graft survival rate was significantly better in conjunctival limbal autograft compared to keratolimbal allograft when comparing the long-term outcome of limbal stem cell transplantation for management of total limbal stem cell deficiency due to chemical burn.