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Limbal Autografting: Comparison of Results in the Acute and Chronic Phases of Ocular Surface Burns.

Rao, Srinivas K. D.O.; Rajagopal, Rama D.O.; Sitalakshmi, G. D.O.; Padmanabhan, Prema M.S.

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Purpose: To compare outcomes of limbal autograft transplantation (LAT) in the acute and chronic phases of ocular surface burns.

Methods: Retrospective analysis of case records of 16 consecutive patients who underwent LAT for ocular surface burns, at our institute, between April 1994 and March 1997.

Results: Limbal autograft transplantation was successful in reconstructing the corneal surface and restoring ocular comfort in 15 (93.8%) eyes. Limbal autografting failed to reconstruct the ocular surface in one patient undergoing surgery 2 weeks after grade IV alkali burns. In 13 eyes with counting fingers or worse vision, functional success (visual acuity >20/400) was attained after LAT in nine (69.2%) eyes. Visual acuity greater than equal to20/80 was achieved in two (25%) of eight eyes undergoing surgery for a persistent epithelial defect (PED) and five of six (83.3%) eyes undergoing surgery after the epithelial defect had healed (p = 0.03). Nine patients underwent simultaneous superior and inferior limbal autografting. Mean epithelial healing time in six of these patients undergoing surgery in the acute phase of injury (<4 months) was 15 +/- 6.1 days. In three patients undergoing a similar procedure in the chronic phase of injury, the healing time was 8.3 +/- 6.7 days.

Conclusions: Limbal autograft transplantation is successful in reconstructing the corneal surface and restoring ocular comfort after ocular surface burns. Surgery in the acute phase of injury (<4 months), in the presence of a PED, could result in delayed corneal reepithelialization and poorer visual prognosis. If performed in the acute phase of injury, LAT should be performed after adequate limbal vascularization and resolution of surface inflammation in the recipient eye, avoiding graft placement over ischemic limbus.

(C) 1999 Lippincott Williams & Wilkins, Inc.


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