Is simple limbal epithelial transplant surgery of high risk?

Question

Hello doctor,

I am a 27 year old male. One year ago, there was a chemical injury to my right eye caused by cement. An amnio graft surgery was done immediately following the injury. Recently, a slit lamp examination, post-dilated examination, and a fundus examination were conducted, and my right eye was diagnosed as 'total LSCD s/p chemical injury' and I was suggested a simple limbal epithelial transplant. Now, is there any possibility to get back my vision in the right eye? Is there a risk to the left eye by doing this transplant? Kindly explain.

Answer 1

Hello,

Welcome to iclinq.com.

I read your query and understood your concern.

Chemical injury damages the cornea and the vision is also compromised. You had an amniotic membrane transplant in the past, which is a good procedure. Now, if you have been diagnosed with limbal stem cell deficiency and a simple limbal epithelial transplant has been suggested, then the chances of decompensation of the cornea are less. Secondly, if your retina is alright, your vision should be back grossly. The important thing is your vision status, post the chemical injury and after the AMG (amnio graft) implant. If it was greater than 6/60, it should improve now by one or two lines. Moreover, it also depends on how much of the cornea is involved and how deeply. My guess is, if they are doing an epithelial transplant of the limbal area, then the rest of the cornea is spared. Your vision should improve, but will never be as normal as the other eye. The post-operative period is very important as there are high chances of graft rejection. Do attach your images and the prescription to help assess the prognosis.

Answer 2

Hello,

I have gone through the images (attachment removed to protect patient identity). It is good that yours donor eye will be yours, as there is a high chance of a rejection otherwise. Your cornea is already compromised, as it has developed a symblepharon. There is total vascularisation. So, there is a low chance for significant vision improvement. The procedure is being done to prevent total blindness. There will be no effect on the other eye. The only important thing is to keep it well lubricated. And there is optic nerve with high ratio. So, keep your intraocular pressure under control. Follow up visit is mandatory . Be regular.