Table 1.
Preoperative data and outcomes at 12 months of 20 eyes with ocular surface failure due to limbal stem cell deficiency syndrome (LSCD) subjected to cultivated limbal epithelial transplantation (CLET).
| Eye number/gender/age | LSCD etiology/group∗/grade† |
Cell source | OSDI I/F |
NEI-VFQ-25I/F | Visual potential‡ | BCVA I/F |
Ciliary hyperemia (0–4) I/F | Central corneal epithelial opacity (0–4) I/F |
Corneal neovessels area (0–4) I/F |
Corneal neovessels length (0–4) I/F |
Central corneal epithelial irregularity (0–3) I/F |
SPK (Fluor) (0–5) I/F |
PED (0–4) I/F |
Epithelial phenotype (IVCM) I/F |
One-year final outcome Comments |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1/M/47 | Chemical injury/1/T | Auto- | 77.0/39.5 | 68.8/68.8 | 4 | 0.05/0.001 | 3/2 | 4/4 | 4/4 | 3/4 | 3/3 | 0/2 | 0/0 | Mixed/Conj |
Failure month 3
2nd CLET (number16) |
| 2/F/71 | Multiple surgeries/3/S | Auto- | 45.0/25.0 | 71.4/74.5 | 0 | 0.00001/0.00001 | 3/0 | 1/0 | 3/0 | 2/0 | 3/1 | 3/1 | 1/0 | Mixed/corneal | Success |
| 3/F/79 | Multiple surgeries/3/T | Auto- | 28.0/20.0 | 68.8/74.4 | 0 | 0.00001/0.00001 | 1/0 | 3/2 | 3/1 | 2/1 | 3/1 | 4/0 | 0/0 | Conj/corneal | Success |
| 4/M/69 | Multiple surgeries/3/T | Auto- | 44.0/9.4 | 87.8/89.7 | 0 | 0.00001/0.00001 | 2/0 | 3/2 | 4/2 | 3/2 | 2/1 | 3/0 | 2/0 | Conj/mixed | Success |
| 5/F/63 | Stevens Johnson/2/S | Allo- | 65.0/50.0 | 71.6/71.6 | 1 | 0.05/0.06 | 3/1 | 2/0 | 2/2 | 2/2 | 3/1 | 3/1 | 1/0 | Mixed/corneal |
Success
Failure month 35 |
| 6/M/62 | MMP/2/S | Allo- | 4.1/0.3 | 91.9/91.9 | 1 | 0.8/0.8 | 3/0 | 1/0 | 4/0 | 4/0 | 2/1 | 3/0 | 0/0 | Mixed/corneal | Success |
| 7/M/66 | Multiple surgeries/3/S | Auto- | 47.0/67.8 | 81.2/84.2 | 0 | 0.001/0.001 | 3/1 | 3/2 | 4/2 | 4/3 | 3/2 | 3/0 | 1/0 | Mixed/corneal | Success |
| 8/M/36 | Chemical injury/1/S | Auto- | 31.0/29.1 | 80.6/80.6 | 1 | 0.25/0.6 | 2/1 | 3/1 | 2/1 | 4/2 | 3/1 | 2/0 | 0/0 | Conj/corneal | Success |
| 9/F/34 | Stevens Johnson/2/T | Allo- | 98.0/89.5 | 40.7/57.4 | 1 | 0.05/0.2 | 3/2 | 2/1 | 1/0 | 1/1 | 2/1 | 4/1 | 1/0 | Conj/corneal | Success |
| 10/F/63 | Stevens Johnson/2/T | Allo- | 78.0/30.0 | 52.1/76.9 | 1 | 0.5/0.8 | 3/2 | 2/0 | 4/3 | 3/1 | 2/1 | 2/1 | 1/0 | Conj/corneal | Success |
| 11/M/27 | Postinfectious keratitis, PKP/3/T | Auto- | 46.0/22.7 | 69.1/72.8 | 4 | 0.001/0.001–0.4 after 2nd surgery | 4/1 | 4/3 | 3/1 | 2/1 | 3/2 | 2/0 | 0/0 | Conj/mixed |
Success
PKP + cataract (month14) + valve |
| 12/M/52 | Postinfectious keratitis/3/T | Auto- | 62.5/5.0 | 93.0/95.3 | 3 | 0.05/0.2 | 1/0 | 3/2 | 4/2 | 4/2 | 3/2 | 2/0 | 0/0 | Conj/mixed |
Success
Refused PKP |
| 13/M/36 | Chemical injury/1/S | Auto- | 8.3/8.3 | 79.6/74.7 | 3 | 0.2/0.5 | 1/0 | 3/1 | 2/1 | 3/2 | 3/1 | 0/0 | 0/0 | Conj/corneal | Success |
| 14/F/54 | Postinfectious keratitis, PKP; RD surgeries/3/T | Auto- | 28.0/18.8 | 81.9/84.7 | 4 | 0.0001/0.001–0.01 after 2nd surgery | 2/1 | 4/2 | 4/3 | 3/2 | 2/1 | 4/1 | 0/0 | Conj/mixed |
Success
PKP + cataract (month 30) |
| 15/M/37 | Congenital aniridia/3/S | Allo- | 98.0/56.8 | 16.2/28.1 | 4 | 0.001/0.01 | 3/1 | 3/2 | 3/2 | 3/2 | 3/1 | 4/1 | 2/0 | Conj/mixed |
Success
Refused further surgeries |
| 16/M/48 | Chemical injury; previous CLET (number 1)/1/T | Allo- | 33.0/22.7 | 66.6/64.3 | 3 | 0.001/0.001 | 3/2 | 3/3 | 4/4 | 4/4 | 2/1 | 2/2 | 0/0 | Conj/Conj |
Partial success
Refused PKP |
| 17/M/52 | Chemical injury/1/T | Allo- | 52.0/50.0 | 12.6/37.7 | 4 | 0.001/0.001 | 3/1 | 4/4 | 3/3 | 3/3 | 3/3 | 3/3 | 0/0 | Conj/Conj | Failure month 4 |
| 18/F/33 | Chemical injury, PKP, severe ocular allergy/1/T | Allo- | 65.0/22.7 | 60.9/73.0 | 4 | 0.62/0.01 | 4/2 | 4/4 | 4/4 | 4/4 | 3/3 | 2/3 | 0/0 | Mixed/Conj | Failure month 9 |
| 19/F/49 | Congenital aniridia/3/T | Allo- | 47.7/63.6 | 35.3/33.1 | 2 | 0.02/0.05 | 3/0 | 2/1 | 4/1 | 3/2 | 3/1 | 2/0 | 0/0 | Mixed/corneal | Success |
| 20/M/53 | Chemical injury/1/S | Auto- | 31.3/9.4 | 63.7/96.3 | 1 | 0.5/0.8 | 2/1 | 3/1 | 1/1 | 1/2 | 3/1 | 4/0 | 2/0 | Conj/corneal | Success |
| Mean (SD) | — | — | 49.5 (25.8)/34.3 (23.4) | 64.7 (22.9)/71.5 (19.4) | 0.15 (0.25)/0.20 (0.31) | — | — | — | — | — | — | — | — | — | |
| Median (IQR) | — | — | — | — | . | 3.0 (1.0)/1.0 (1.3) | 3.0 (1.3)/2.0 (1.3) | 3.5 (1.3)/2.0 (2.0) | 3.0 (2.0)/2.0 (1.3) | 3.0 (1.0)/1.0 (1.0) | 3.0 (1.3)/0.5 (1.0) | 0.0 (1.0)/0.0 (0.0) | — | — |
∗Group 1: chemical injuries, Group 2: immune-based inflammatory diseases, Group 3: noninflammatory diseases; †T: total, S: severe; ‡visual potential: 1, improvement with CLET only (corneal opacity was only superficial); 2, improvement with one surgery different from corneal transplant after CLET (i.e., cataract removal); 3, improvement with subsequent corneal transplant after CLET (corneal opacity was full thickness); 4, improvement with subsequent corneal transplant plus another surgery (cataract removal unless otherwise specified) after CLET, and 0: no possibility of improvement (i.e., due to irreversible retinal pathology). Auto-, autologous; Allo-, allogeneic; BCVA, best corrected visual acuity; BCVA values 0.01, 0.001, 0.0001, and 0.00001 equivalent to counting fingers, hand motion, light perception, and no light perception, respectively; Conj, conjunctival; Fluor, fluorescein staining; IQR, interquartile range; IVCM, in vivo confocal microscopy; MP, mucous membrane pemphigoid; NEI-VFQ-25, National Eye Institute-Visual Function Questionnaire; OSDI, ocular surface disease index; SPK, superficial punctate keratitis; PED, persistent epithelial defect; PKP, penetrating keratoplasty; and SD, standard deviation.