keratolimbal allograft in total limbal stem cell deficiency

purpose: to investigate the outcomes of keratolimbal allograft (klal) for treatment of total limbal stem cell deficiency (lscd). method: patients with total lscd and adequate tear production were included. a total of 27 klal procedures were performed in 21 eyes of 20 patients with lscd. immunosuppression was achived using mycophenolate and cyclosporine. main outcome measure was improvement in vision; in addition, klal survival and post operative complications were studied. results: mean follow up period was 22.14±11.83 months (range 6-39). mean visual acuity improved from 2.53± 0.21 to 1.49±0.77 logmar (p<0.0001). six klals never re-epithelialized and were considered as primary failures. mean klal survival was 14.23±1.5 months. graft survival rate was 61.9% at 1 year and 31% at 20 months. complications included corneal ulcers in 6, glaucoma in 2 and scleral thining in 1 case. conclusion: keratolimbal allograft surgery is successful in the short term for visual rehabilitation of patients with total limbal stem cell deficiency.