Optimizing Keratolimbal Allograft Outcomes: Optical Coherence Tomography Analysis of Donor Graft Phenotypes in Limbal Stem Cell Deficiency.

IF 1.9 3区 医学 Q2 OPHTHALMOLOGY
Wenyu Wu, Szy Yann Chan, Haozhe Yu, Qiaoyu Li, Yun Feng
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Abstract

Purpose: To evaluate the morphology of donor grafts and limbal microstructure after keratolimbal allograft (KLAL) surgery using anterior segment optical coherence tomography (AS-OCT) and to explore the relationship between graft shape and clinical outcomes.

Methods: This retrospective study included patients with limbal stem cell deficiency from severe ocular surface burns who underwent KLAL with or without concurrent keratoplasty. AS-OCT was used to assess graft morphology and the graft-recipient interface. Grafts were classified into 3 types-wedge-shaped, trapezoidal, and irregular-shaped-based on AS-OCT imaging. Postoperative clinical outcomes, including neovascularization, conjunctivalization, and corneal opacity, were recorded and compared across graft types.

Results: Among 26 eyes from 23 patients, wedge-shaped grafts showed significantly higher success rates, with fewer complications of neovascularization, conjunctivalization, and corneal opacity, compared with trapezoidal and irregular-shaped grafts. Specifically, wedge-shaped grafts had superior outcomes in neovascularization (vs. trapezoidal: χ2 = 5.658, P = 0.017; vs. irregular: χ2 = 6.062, P = 0.014), conjunctivalization (vs. trapezoidal: χ2 = 5.855, P = 0.016; vs. irregular: χ2 = 6.814, P = 0.009), and corneal opacity (vs. trapezoidal: χ2 = 7.088, P = 0.008). AS-OCT imaging showed closer adherence of wedge-shaped grafts to the recipient bed, potentially enhancing stability, whereas trapezoidal and irregular-shaped grafts exhibited gaps that may hinder attachment.

Conclusions: AS-OCT imaging effectively visualizes donor graft morphology and graft-recipient microstructure, providing insights into KLAL outcomes. Wedge-shaped grafts, which align more closely with natural limbal anatomy, show greater ocular surface stability.

优化角膜缘异体移植结果:角膜缘干细胞缺乏供体移植表型的光学相干断层扫描分析。
目的:应用前段光学相干断层扫描(AS-OCT)评价同种异体角膜缘移植(KLAL)术后供体形态和角膜缘显微结构,探讨移植物形态与临床疗效的关系。方法:这项回顾性研究包括严重眼表烧伤后角膜缘干细胞缺乏的患者,他们接受KLAL合并或不合并角膜移植术。应用AS-OCT评价移植物形态和移植物-受体界面。基于AS-OCT成像将移植物分为楔形、梯形和不规则3种类型。术后临床结果,包括新生血管形成、结膜形成和角膜混浊,记录并比较不同移植类型。结果:在23例患者26只眼中,楔形移植的成功率明显高于梯形和不规则移植,其新生血管形成、结膜形成、角膜混浊等并发症较少。具体而言,楔形移植物在新生血管方面的效果优于梯形移植物(χ2 = 5.658, P = 0.017;与不规则:χ2 = 6.062, P = 0.014),结膜炎(与梯形:χ2 = 5.855, P = 0.016;与不规则:χ2 = 6.814, P = 0.009)和角膜混浊(与梯形:χ2 = 7.088, P = 0.008)。AS-OCT成像显示楔形移植物与受体床的粘附更紧密,可能增强稳定性,而梯形和不规则形状的移植物则表现出可能阻碍附着的间隙。结论:AS-OCT成像有效地显示供体移植物形态学和移植物受体微观结构,为KLAL结果提供见解。楔形移植物更接近自然角膜缘解剖结构,显示出更大的眼表稳定性。
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来源期刊
Cornea
Cornea 医学-眼科学
CiteScore
5.20
自引率
10.70%
发文量
354
审稿时长
3-6 weeks
期刊介绍: For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.
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