Clinical outcomes of simple limbal epithelial transplantation for limbal stem cell deficiency in a Mexican population.

Abstract

Purpose: To report the clinical outcomes of simple limbal epithelial transplantation (SLET) in patients with limbal stem cell deficiency (LSCD).

Methods: Retrospective case series of patients with LSCD who underwent either Auto-SLET or Allo-SLET at a tertiary center in Mexico from 2020 to 2023. Demographic and clinical data, including underlying etiology, best corrected visual acuity, and graft survival, were collected and analyzed.

Results: Eighteen eyes of 18 patients were studied, with a mean age of 34.05 ± 22.88 years. The underlying etiologies of LSCD were alkali chemical injury (n = 10, 55.55%), acid chemical injury (n = 3, 16.66%), pterygium (n = 2, 11.11%), thermal burn (n = 2, 11.11%), and Stevens-Johnson syndrome (SJS) (n = 1, 5.55%). The mean follow-up was 26.05 ± 11.09 months. Auto-SLET and Allo-SLET were performed in 88.88% and 11.11% of the cases, respectively. Clinical success was achieved in 72.22% of cases, with failures associated with acid chemical injury (n = 2), alkali chemical injury (n = 2), and SJS (n = 1). Best-corrected visual acuity (BCVA) improved significantly from 1.58 ± 0.81 logMAR to 1.11 ± 0.75 logMAR (P = 0.05). The mean survival time of all SLET procedures was 623.38 ± 458.70 days. Kaplan-Meier analysis showed varied survival times across different etiologies: alkali injury (719.5 ± 444.3 days), pterygium (328 ± 118.79 days), acid injury (593 ± 831.7 days), thermal burn (663 ± 39.59 days), and SJS (265 days), with an overall survival probability of 72% at 500 days.

Conclusions: Clinical success was achieved in 72.22% of cases. SLET and derived techniques have proven safe and effective as viable treatments for LSCD. This relatively straightforward and efficient technique has yielded positive outcomes across various etiologies of LSCD in our population.