Keratolimbal Allograft in Total Limbal Stem Cell Deficiency

To investigate the outcomes of keratolimbal allograft (KLAL) for treatment of total limbal stem cell deficiency (LSCD). Patients with total LSCD and adequate tear production were included. A total of 27 KLAL procedures were performed in 21 eyes of 20 patients with LSCD. Immunosuppression was achived using mycophenolate and cyclosporine. Main outcome measure was improvement in vision; in addition, KLAL survival and post operative complications were studied. Mean follow up period was 22.14±11.83 months (range 6-39). Mean visual acuity improved from 2.53± 0.21 to 1.49±0.77 LogMAR (P<0.0001). Six KLALs never re-epithelialized and were considered as primary failures. Mean KLAL survival was 14.23±1.5 months. Graft survival rate was 61.9% at 1 year and 31% at 20 months. Complications included corneal ulcers in 6, glaucoma in 2 and scleral thining in 1 case. Keratolimbal allograft surgery is successful in the short term for visual rehabilitation of patients with total limbal stem cell deficiency.