Keratolimbal Allograft in the Management of Delayed-Onset Mustard Gas Keratopathy: Long-term Results

Purpose: To evaluate the long-term results of Keratolimbal allograft (KLAL) in the management of Delayed-onset Mustard Gas Keratopathy (MGK). Methods: This cross-sectional descriptive study considers those patients with documented MGK, who underwent KLAL between 2002 and 2016 in the Department of ophthalmology, Labbafinejad Medical Center. After obtaining consent, the patients were followed closely and finally recalled for complete ophthalmic examination. The, the data were statistically analyzed. The cumulative survival rate of the KLAL’s was the main measured outcome. Results: A total of 108 eyes of 68 cases of MGK underwent KLAL. All the patients were men with an average age of 54±6 years. The average follow-up duration was 81.9±38.4 months. KLAL types were: Segmental in 62, with Lamellar Keratoplasty (LKP) in 40 and with Penetrating Keratoplasty (PKP) in 6 eyes. Of these eyes, 88.1% underwent only one operation for stabilizing the ocular surface. Average BCVA did not change after KLAL except improving in those cases accompanied by LKP. After this follow-up, 75% of KLAL survived, with the best results in those with LKP. Infectious keratitis occurred in 6 (5.5%) eyes. No case of adverse effect secondary to systemic immunosuppression was reported. Conclusion: KLAL techniques alone or with LKP are effective, durable, and visually acceptable in the replacement of damaged stem-cells and opacified cornea in cases of MGK.