SIMPLE EPITHELIAL TRANSPLANTATION FOR OCULAR SURFACE RECONSTRUCTION AFTER SEVERE OCULAR BURN INJURY
Author: Camilla Pagnacco
Base Hospital / Institution: University Hospital of Verona
ePoster presentation
Abstract ID: 24-329
Purpose
A new surgical two step procedure developed to manage ocular surface complications and recover conjunctival and corneal epithelia after unilateral severe chemical burn.
Methods
Following lysis of cicatricial symblepharon and scar tissue, we performed simple conjunctival epithelial transplantation (SCET) to obtain renew of fornix and bulbar-tarsal conjunctiva epithelium, followed by simple limbal epithelial transplantation (SLET) to recover limbal function and epithelial corneal surface. Slit lamp examination, fluorescein-staining, in vivo confocal microscopy (IVCM), Wong–Baker FACES Pain Rating Scale (WBFPS) and best corrected visual acuity (BCVA) were assessed before surgery, at 1 and 3 months after SCET and SLET, and thereafter at 6, 12, and 36 months.
Results
Two patients underwent surgery. Eye mobility and fornix reconstruction were obtained, and conjunctival epithelium with goblet cells was observed onto the bulbar and tarsal conjunctiva 3 months after SCET. Subsequently, SLET was performed and corneal epithelium and cornea-conjunctiva transition zone were observed at 3 and 6 months, respectively. From before surgery to 6 months after SLET, the WBFPS changed from grade 6 and 4 to grade 0, and the BCVA improved from 1.40 and 1.10 LogMAR to 0.5 LogMAR, in patient 1 and patient 2, respectively. At the 3-year follow-up, results remained stable. No adverse events were observed.
Conclusion
The SCET and SLET sequential surgery showed to be effective in restoring a normal ocular surface with long-lasting results. Combined with symblepharon lysis, SCET effectively healed the bare conjunctival area without scar recurrence and relieved subjective symptoms and eye discomfort. SLET showed further improvement and long-term stability suggesting that the aim in patients with severe ocular burn is not merely the corneal epithelium renewal but also the regeneration of ocular surface homeostasis
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Erika | Bonacci | University Hospital of Verona |
| Adriano | Fasolo | Research Unit, The Veneto Eye Bank Foundation |
| Emilio | Pedrotti | University Hospital of Verona |
| Giorgio | Marchini | University Hospital of Verona |
