Allograft conjunctival transplantation for bilateral ocular surface disorders

Ophthalmology. 1995 Jul;102(7):1020-5. doi: 10.1016/s0161-6420(95)30918-9.

Abstract

Purpose: The purpose of this study is to evaluate the efficacy of allogenic conjunctival transplantation in bilateral surface disorders and to correlate with human leukocyte antigen (HLA) typing and cross-matching.

Methods: A prospective study of allogenic conjunctival transplantation was undertaken in 12 eyes of 10 patients with bilateral surface disorders. Five eyes had Stevens-Johnson syndrome, three had Lyell syndrome, three had bilateral alkali burns, and one had a bilateral thermal burn. Human leukocyte antigen typing and cross-matching were retrospectively performed in eight patients and their respective donors. Stabilization of corneal epithelia, visual acuity, and rejection episodes were examined after the procedure.

Results: Eleven (91.6%) of 12 eyes had improved visual acuity, corneal transparency and surface lubrication, stabilization of corneal epithelia, and decreased corneal neovascularization and photophobia after an average follow-up of 17.2 months. Three patients (25%) had rejection episodes, with no disturbance in corneal surface in two. Two of these three patients had 100% incompatible HLA donor-recipient pairs; HLA of the third patient was not available. Patients with favorable evolution were either HLA identical or haplo-identical (50% identity) with their donors. Donor eyes did not present any epithelial problems during the follow-up period.

Conclusions: Human leukocyte antigen-matched allogenic conjunctival transplantation proved to be an adequate method of treating severe bilateral surface disorders, with minimal complications.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Conjunctiva / immunology
  • Conjunctiva / transplantation*
  • Corneal Diseases / etiology
  • Corneal Diseases / physiopathology
  • Corneal Diseases / surgery*
  • Epithelium / immunology
  • Epithelium / transplantation
  • Female
  • Graft Rejection / etiology
  • Graft Rejection / physiopathology
  • HLA Antigens / analysis
  • Histocompatibility Testing
  • Humans
  • Male
  • Prospective Studies
  • Transplantation, Homologous
  • Treatment Outcome
  • Visual Acuity / physiology

Substances

  • HLA Antigens