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TitleVisual rehabilitation using a scleral contact lens following cultivated limbal stem cell transplantation.
PurposeTo describe a case of unilateral total limbal stem cell deficiency (LSCD) resolved by ocular surface reconstruction using cultured autologous limbal stem cells, corneal transplant and a scleral lens. To our knowledge, this is the first documented case of scleral lens usage in this pathology.
MethodsA 55-year-old, HIV-positive male suffered a unilateral alkali burn 16 years ago, resulting in a total LSCD. The patient had received a previous penetrating keratoplasty (PK) that ultimately failed to impede corneal conjunctivalization. Upon referral, diagnosis of LSCD was made on clinical grounds. We elected to perform an ex-vivo cultivated limbal epithelial stem cell transplantation (CLET) using a small limbal graft from the contralateral, healthy eye. To remove deep stromal scarring, the patient received a second PK one year after transplantation. One year later, the patient was fitted with a scleral lens.
ResultsOne year after PK, the patient’s vision had improved from hand movements initially to 0.5 with optimal correction, and the ocular surface was stable with a transparent corneal graft. Using a scleral lens, the patient’s best-corrected vision improved significantly from 0.5 to 1.0.
ConclusionThis case illustrates the fact that CLET can be successfully utilized to restore a stable corneal surface with consequent improvement in visual acuity, and this in cases of severe total LSCD such as chemical burns. Furthermore, it also highlights the beneficial role of scleral lenses to achieve excellent functional outcomes in these patients.
Conflict of interestNo
Authors 1
Last nameBALLET
DepartmentUniversitair Ziekenhuis Antwerpen
Authors 2
DepartmentUniversitair Ziekenhuis Brussel
Authors 3
DepartmentUniversitair Ziekenhuis Antwerpen
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