Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency: Multicentre results

Jayesh Vazirani, Mohammed Hasnat Ali, Namrata Sharma, Nidhi Gupta, Vikas Mittal, Marwan Atallah, Guillermo Amescua, Tuhin Chowdhury, Alexandra Abdala-Figuerola, Arturo Ramirez-Miranda, Alejandro Navas, Enrique O. Graue-Hernández, James Chodosh

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Purpose To report outcomes of autologous simple limbal epithelial transplantation (SLET) performed for unilateral limbal stem cell deficiency (LSCD) at multiple centres worldwide. Methods In this retrospective, multicentre, interventional case series, records of patients who had undergone autologous SLET for unilateral LSCD, with a minimum of 6 months of follow-up, were reviewed. The primary outcome measure was clinical success, defined as a completely epithelised, avascular corneal surface. Kaplan-Meier survival curves were constructed and survival probability was calculated. A Cox proportional hazards analysis was done to assess association of preoperative characteristics with risk of failure. Secondary outcome measures included the percentage of eyes achieving visual acuity of 20/200 or better, percentage of eyes gaining two or more Snellen lines and complications encountered. Results 68 eyes of 68 patients underwent autologous SLET, performed across eight centres in three countries. Clinical success was achieved in 57 cases (83.8%). With a median follow-up of 12 months, survival probability exceeded 80%. Presence of symblepharon (HR 5.8) and simultaneous keratoplasty (HR 10.8) were found to be significantly associated with a risk of failure. 44 eyes (64.7%) achieved a visual acuity of 20/200 or better, and 44 eyes (64.7%) gained two or more Snellen lines. Focal recurrences of pannus were noted in 21 eyes (36.8%) with clinical success. Conclusion Autologous SLET is an effective and safe modality for treatment of unilateral LSCD. Clinical success rates and visual acuity improvement are equal to or better than those reported with earlier techniques.

Original languageEnglish (US)
JournalBritish Journal of Ophthalmology
DOIs
StateAccepted/In press - Jan 27 2016

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Stem Cells
Transplantation
Visual Acuity
Outcome Assessment (Health Care)
Corneal Transplantation
Survival
Kaplan-Meier Estimate
Recurrence
Therapeutics

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency : Multicentre results. / Vazirani, Jayesh; Ali, Mohammed Hasnat; Sharma, Namrata; Gupta, Nidhi; Mittal, Vikas; Atallah, Marwan; Amescua, Guillermo; Chowdhury, Tuhin; Abdala-Figuerola, Alexandra; Ramirez-Miranda, Arturo; Navas, Alejandro; Graue-Hernández, Enrique O.; Chodosh, James.

In: British Journal of Ophthalmology, 27.01.2016.

Research output: Contribution to journalArticle

Vazirani, J, Ali, MH, Sharma, N, Gupta, N, Mittal, V, Atallah, M, Amescua, G, Chowdhury, T, Abdala-Figuerola, A, Ramirez-Miranda, A, Navas, A, Graue-Hernández, EO & Chodosh, J 2016, 'Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency: Multicentre results', British Journal of Ophthalmology. https://doi.org/10.1136/bjophthalmol-2015-307348
Vazirani, Jayesh ; Ali, Mohammed Hasnat ; Sharma, Namrata ; Gupta, Nidhi ; Mittal, Vikas ; Atallah, Marwan ; Amescua, Guillermo ; Chowdhury, Tuhin ; Abdala-Figuerola, Alexandra ; Ramirez-Miranda, Arturo ; Navas, Alejandro ; Graue-Hernández, Enrique O. ; Chodosh, James. / Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency : Multicentre results. In: British Journal of Ophthalmology. 2016.
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abstract = "Purpose To report outcomes of autologous simple limbal epithelial transplantation (SLET) performed for unilateral limbal stem cell deficiency (LSCD) at multiple centres worldwide. Methods In this retrospective, multicentre, interventional case series, records of patients who had undergone autologous SLET for unilateral LSCD, with a minimum of 6 months of follow-up, were reviewed. The primary outcome measure was clinical success, defined as a completely epithelised, avascular corneal surface. Kaplan-Meier survival curves were constructed and survival probability was calculated. A Cox proportional hazards analysis was done to assess association of preoperative characteristics with risk of failure. Secondary outcome measures included the percentage of eyes achieving visual acuity of 20/200 or better, percentage of eyes gaining two or more Snellen lines and complications encountered. Results 68 eyes of 68 patients underwent autologous SLET, performed across eight centres in three countries. Clinical success was achieved in 57 cases (83.8{\%}). With a median follow-up of 12 months, survival probability exceeded 80{\%}. Presence of symblepharon (HR 5.8) and simultaneous keratoplasty (HR 10.8) were found to be significantly associated with a risk of failure. 44 eyes (64.7{\%}) achieved a visual acuity of 20/200 or better, and 44 eyes (64.7{\%}) gained two or more Snellen lines. Focal recurrences of pannus were noted in 21 eyes (36.8{\%}) with clinical success. Conclusion Autologous SLET is an effective and safe modality for treatment of unilateral LSCD. Clinical success rates and visual acuity improvement are equal to or better than those reported with earlier techniques.",
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AU - Ali, Mohammed Hasnat

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AU - Gupta, Nidhi

AU - Mittal, Vikas

AU - Atallah, Marwan

AU - Amescua, Guillermo

AU - Chowdhury, Tuhin

AU - Abdala-Figuerola, Alexandra

AU - Ramirez-Miranda, Arturo

AU - Navas, Alejandro

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AU - Chodosh, James

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N2 - Purpose To report outcomes of autologous simple limbal epithelial transplantation (SLET) performed for unilateral limbal stem cell deficiency (LSCD) at multiple centres worldwide. Methods In this retrospective, multicentre, interventional case series, records of patients who had undergone autologous SLET for unilateral LSCD, with a minimum of 6 months of follow-up, were reviewed. The primary outcome measure was clinical success, defined as a completely epithelised, avascular corneal surface. Kaplan-Meier survival curves were constructed and survival probability was calculated. A Cox proportional hazards analysis was done to assess association of preoperative characteristics with risk of failure. Secondary outcome measures included the percentage of eyes achieving visual acuity of 20/200 or better, percentage of eyes gaining two or more Snellen lines and complications encountered. Results 68 eyes of 68 patients underwent autologous SLET, performed across eight centres in three countries. Clinical success was achieved in 57 cases (83.8%). With a median follow-up of 12 months, survival probability exceeded 80%. Presence of symblepharon (HR 5.8) and simultaneous keratoplasty (HR 10.8) were found to be significantly associated with a risk of failure. 44 eyes (64.7%) achieved a visual acuity of 20/200 or better, and 44 eyes (64.7%) gained two or more Snellen lines. Focal recurrences of pannus were noted in 21 eyes (36.8%) with clinical success. Conclusion Autologous SLET is an effective and safe modality for treatment of unilateral LSCD. Clinical success rates and visual acuity improvement are equal to or better than those reported with earlier techniques.

AB - Purpose To report outcomes of autologous simple limbal epithelial transplantation (SLET) performed for unilateral limbal stem cell deficiency (LSCD) at multiple centres worldwide. Methods In this retrospective, multicentre, interventional case series, records of patients who had undergone autologous SLET for unilateral LSCD, with a minimum of 6 months of follow-up, were reviewed. The primary outcome measure was clinical success, defined as a completely epithelised, avascular corneal surface. Kaplan-Meier survival curves were constructed and survival probability was calculated. A Cox proportional hazards analysis was done to assess association of preoperative characteristics with risk of failure. Secondary outcome measures included the percentage of eyes achieving visual acuity of 20/200 or better, percentage of eyes gaining two or more Snellen lines and complications encountered. Results 68 eyes of 68 patients underwent autologous SLET, performed across eight centres in three countries. Clinical success was achieved in 57 cases (83.8%). With a median follow-up of 12 months, survival probability exceeded 80%. Presence of symblepharon (HR 5.8) and simultaneous keratoplasty (HR 10.8) were found to be significantly associated with a risk of failure. 44 eyes (64.7%) achieved a visual acuity of 20/200 or better, and 44 eyes (64.7%) gained two or more Snellen lines. Focal recurrences of pannus were noted in 21 eyes (36.8%) with clinical success. Conclusion Autologous SLET is an effective and safe modality for treatment of unilateral LSCD. Clinical success rates and visual acuity improvement are equal to or better than those reported with earlier techniques.

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