Unusual intermediate-term outcome in three cases of limbal autograft transplantation

Ophthalmology. 1999 May;106(5):958-63. doi: 10.1016/S0161-6420(99)00516-3.


Objective: To report an unusual intermediate-term outcome after limbal autograft transplantation for unilateral, severe chemical burns.

Design: Case reports of three consecutive cases.

Participants: Three patients with a history of chemical burns. The fellow eye was clinically uninvolved in all patients. Surgery was indicated for conjunctivalization (cases 1 and 3) and persistent epithelial defect (case 2).

Intervention: Three (cases 2 and 3) or four (case 1) 1.25-clock-hour-wide limbal grafts were harvested from the fellow eye and transplanted to the limbus in the affected eye. Surface re-epithelialization, improvement in visual acuity, and maintenance of surface stability were monitored.

Results: Limbal grafts were effective in re-epithelialization of the corneal surface within 4 weeks in all cases. Symptomatic relief and improvement in visual acuity were noted during early follow-up. However, a progressive conjunctival ingrowth that tended to override the grafts and encroach the visual axis was noted over the course of a year in all three recipient eyes.

Conclusions: Limbal autograft transplantation is an effective method for surface re-epithelialization in strictly unilateral chemical burns. Caution should be exercised in case selection. The authors' experience suggests a variable degree of attenuation in viability of transplanted limbus. Close follow-up of operated eyes is necessary to determine the long-term efficacy of limbal transplants as a source of corneal phenotypic cells.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Burns, Chemical / pathology
  • Burns, Chemical / surgery*
  • Cell Transplantation*
  • Epithelial Cells / transplantation
  • Eye Burns / chemically induced*
  • Eye Burns / pathology
  • Follow-Up Studies
  • Humans
  • Limbus Corneae / cytology*
  • Limbus Corneae / surgery*
  • Male
  • Stem Cell Transplantation*
  • Transplantation, Autologous
  • Treatment Outcome
  • Visual Acuity