Surgical Management of Bilateral Limbal Stem Cell Deficiency

Authors

  • Rosa Lomelino Pinheiro Centro de Responsabilidade Integrado de Oftalmologia. Centro Hospitalar e Universitário de Coimbra. Coimbra. https://orcid.org/0000-0002-8621-5816
  • João Gil Centro de Responsabilidade Integrado de Oftalmologia. Centro Hospitalar e Universitário de Coimbra. Coimbra; Faculdade de Medicina. Universidade de Coimbra. Coimbra. https://orcid.org/0000-0001-9032-1008
  • Maria João Quadrado Centro de Responsabilidade Integrado de Oftalmologia. Centro Hospitalar e Universitário de Coimbra. Coimbra; Faculdade de Medicina. Universidade de Coimbra. Coimbra. https://orcid.org/0000-0002-5881-9161
  • Joaquim Murta Centro de Responsabilidade Integrado de Oftalmologia. Centro Hospitalar e Universitário de Coimbra. Coimbra; Faculdade de Medicina. Universidade de Coimbra. Coimbra. https://orcid.org/0000-0001-8926-5176

DOI:

https://doi.org/10.20344/amp.18960

Keywords:

Corneal Diseases/surgery, Epithelium, Corneal, Eye Burns/complications, Limbus Corneae, Ophthalmologic Surgical Procedures, Prosthesis Implantation, Stem Cells

Abstract

At the age of 43 years-old, a man was left with bilateral limbal stem cell deficiency after an ocular alkaline burn with lime, which resulted in corneal opacification. After multiple unsuccessful surgical attempts to restore vision, including penetrating keratoplasties and Boston keratoprosthesis, visual acuity was counting fingers in the left eye. At 73 years of age, the patient underwent another surgery in his left eye. Cauterization of neovessels and removal of the vascular pannus were followed by partial excision of Tenon’s capsule. Penetrating keratoplasty was followed by an intrastromal injection of anti-VEGF (vascular endothelial growth factor), and the ocular surface was covered with amniotic membrane. Postoperatively, the graft was clear with no signs of inflammation; vision improved to 20/50 and remained stable throughout the following two years. Herein we describe some adjunctive procedures that might have delayed failure and rejection of the corneal graft. This case demonstrates the difficulties in treating bilateral limbal stem cell deficiency in a tertiary eye care center with no capacity to perform stem cell therapy.

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References

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Published

2023-02-07

How to Cite

1.
Lomelino Pinheiro R, Gil J, Quadrado MJ, Murta J. Surgical Management of Bilateral Limbal Stem Cell Deficiency. Acta Med Port [Internet]. 2023 Feb. 7 [cited 2024 May 28];36(10):679-82. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/18960

Issue

Section

Case Report