SEP 15, 2014
The authors report on a new technique for treating unilateral limbal stem cell deficiency in which a double amniotic membrane graft is used to protect the transplanted limbal stem cells.
The simple limbal epithelial transplantation (SLET) technique involves removal of one clock hour of healthy limbus from the uninvolved eye. The involved eye is then prepared with a 360-degree limbal peritomy, removal of the pannus, and amniotic membrane transplant (AMT) placement. The harvested limbus is then cut into multiple pieces, placed on the AMT, secured with fibrin glue and covered with a second AMT, which is sutured into place. A temporary bandage contact lens is then placed on the eye.
The authors used this technique in four consecutive patients with unilateral partial or total limbal stem cell deficiency secondary to ocular surface burns, trauma or conjunctival melanoma treatment.
All four patients showed improvement in ocular surface findings, decreased pain and improved vision at six months.
This technique has multiple advantages over previous techniques; it doesn’t require a tissue culture facility, immunosuppression, or chronic glaucoma and infection surveillance. It is a very promising technique for those with unilateral or partial bilateral limbal stem cell deficiency.
The authors note that this procedure was easy to perform and involves only simple surgical techniques that can be replicated by most ophthalmic surgeons. They say the results were comparable with the currently used surgical techniques for management of limbal stem cell deficiency.
They conclude that further studies with more patients and longer follow-up are needed to confirm these initial exciting results.