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Cornea:
doi: 10.1097/ICO.0b013e3181b442ea
Case Report

Ocular Surface Reconstruction With Cultivated Limbal Epithelium in a Patient With Unilateral Stem Cell Deficiency Caused by Epidermolysis Bullosa Dystrophica Hallopeau-Siemens

Thanos, Melissa MD*; Pauklin, Mikk MD*†; Steuhl, Klaus-P MD*; Meller, Daniel MD*

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Abstract

Purpose: To report a case of partial limbal stem cell deficiency (LSCD) caused by epidermolysis bullosa dystrophica mutilans Hallopeau-Siemens treated by transplantation of autologous ex vivo expanded limbal epithelium.

Methods: Review of the clinical findings of an 11.5-year-old boy with unilateral LSCD and epidermolysis bullosa dystrophica who underwent ocular surface reconstruction in the right eye with autologous on intact human amniotic membrane cultivated limbal epithelial cells.

Results: Twenty-eight months after reconstruction, the corneal surface is clear, smooth, and stable showing no signs of LSCD recurrence. Three subconjunctival bevacizumab (Avastin) injections reduced the recurrent growth of symblepharon and corneal vascularization. The visual acuity has increased from hand motion to 20/50.

Conclusion: Autologous transplantation of cultivated human limbal epithelial cells on intact human amniotic membrane can be a safe and effective method for corneal surface reconstruction in LSCD caused by recessive epidermolysis bullosa dystrophica.

© 2010 Lippincott Williams & Wilkins, Inc.

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