Limbal autograft
transplantation is presented in 26 consecutive cases comprising both acute and chronic chemical injury (20 cases), thermal
burns (2 cases),
contact lens-induced keratopathy (3 cases), and ocular surface failure after multiple
surgical procedures (1 case), with follow-up ranging from 2 to 45 months (mean, 18 months). The operative technique usually involved transfer of two free grafts of limbal tissue from the uninjured or less injured donor eye to the severely injured recipient eye, the latter having been prepared by limited conjunctival research and superficial dissection of fibrovascular pannus without
keratectomy. Clinical results in 21 patients with follow-up of 6 months or more have consistently shown improved visual acuity (17 cases), rapid surface healing (19 cases), stable epithelial adhesion without recurrent erosion or persistent epithelial defect (20 cases), arrest or regression of
corneal neovascularization (15 cases), and probable increased success for lamellar or
penetrating keratoplasty (8 cases). No
intraoperative complications were encountered, and no adverse reactions developed in donor eyes. Impression cytology in selected cases showed restoration of the corneal epithelial phenotype and regression of goblet cells from the recipient cornea. Therefore, limbal autograft
transplantation is recommended for treatment of widespread ocular surface damage with loss of limbal epithelial stem cells and, specifically, for chemical or thermal
burns,
contact lens-induced keratopathy, and selected persistent corneal epithelial defects.