Conjunctival autotransplantation-combined large-diameter deep lamellar keratoplasty with corneal limbal stem cells for severe ocular surface burn

Objective To investigate the efficacy of conjunctival autotransplantation-combined large-diameter deep lamellar keratoplasty with corneal limbal stem cells on severe ocular surface burn.Methods Retrospective analyses were conducted on 11 patients(11 eyes) with severe ocular surface burn who had received conjunctival autotransplantation-combined large-diameter deep lamellar keratoplasty with corneal limbal stem cells.Of all the subject eyes,3 eyes were with alkali burn,2 eyes with acid burn,6 eyes with thermal burn;Newly-formed corneal pannus was found in all eyes.Follow-ups of 16-24 months were carried out,postoperative visual acuity,corneal epithelial recovery,corneal transparency,attached growth of grafts,symblepharon recurrence and rejection action were monitored.Results Postoperative double anterior chamber was observed in 2 eyes,the symptom in 1 eye disappeared at the 10th day after the eye was given pressure dressing;The symptom in the other disappeared at the 3th day after the eye was given anterior chamber gas replacement.Graft transparency was 63.6% after the operation 1 year;Graft opacification was observed in 4 eyes.All patients had normal corneal limbal structure after the operation 1 year.The postoperative best corrected visual acuity: 0.6(1 eye),≥0.1(5 eyes), 0.1(5 eyes);Postoperative best corrected visual acuity of all eyes were better than preoperative ones.Conclusion Conjunctival autotransplantation-combined large-diameter deep lamellar keratoplasty with fresh and healthy corneal and scleral material is a safe and effective way in treating severe ocular surface chemical or thermal burn.