PEJMAN BAKHTIARI MD, ALI DJALILIAN MD

Sutureless Keratolimbal Allograft Transplantation for Ocular Surface Reconstruction Using Fibrin Glue Authors have no financial interest regarding this presentation PEJMAN BAKHTIARI MD, ALI DJALILIAN MD

Purpose • To present method and describe visual and anatomic outcomes of sutureless keratolimbal allograft (KLAL) and conjunctivolimbal autograft (CLAU) for oclular surface reconstruction using fibrin glue.

Methods • 21 eyes of 18 consecutive patients with total limbal stem cell deficiency (LSCD) underwent surgery under local anesthesia. • First 360 degrees peritomy was done followed by scar excision and removal. Then superficial keratectomy performed to remove conjunctivalized pannus over the cornea. • Trimmed thin blocks of gafts were secured using Tisseel fibrin glue.

Methods • Two globes of the same donor were requested. • 3 trimmed semilimbal blocks were prepared and transplanted using fibrin glue, each covered 120 degrees of recipients limbus (following picture)

Methods of Keratolimbal Blocks Preparation

Results • 18 patients (12 females and 6 males) with mean age of 43 year-old were underwent surgery. For 18 eye KLAL and for 3 CLAU were performed with mean follow-up of 14.9 months (range: 3-32 months) and all allografts received systemic immunosuppression including prednisone, prograf and cellcept • Mean visual acuity increased from 20/500 to 20/155 (p=0.001) • 15 (78.9%) cases showing an improvement of ≥ 2 snellen lines. • Minimal displacement of less than one mm was noted in 6 eyes, with no functional consequence. • 6 eyes experienced graft rejection; 5 of them required penetrating keratoplasty and the other one received keratoprosthesis. • In remaining 15 eyes corneal surface successfully epithelialized.

Post-operative Photos • 3 weeks and 24 months post-op photos of an aniridic patient has undergone suturless KLAL 3 weeks post-op 24 months post-op

Conclusion • KLAL and CLAU can successfully be done using fibrin glue to secure the graft with good anatomic and functional outcomes. • Sutureless surgery could provide smoother surface and improve patient comfort intra and post-operatively.

PEJMAN BAKHTIARI MD, ALI DJALILIAN MD

PEJMAN BAKHTIARI MD, ALI DJALILIAN MD

Presentation Transcript

Daniele Tognetto MD, Pia Leon MD, Paolo Cecchini MD, Silvia Rinaldi MD, Giuseppe Ravalico MD

Ali AYHAN, MD.

786 DR MASHOOQUE ALI DASTI MD CARDIOLOGY

Faiza Ali MD, Ericka Hayes MD, Gaurav Kaushik MPH, Nicole Carr RN , Katie Plax MD

A Kheirkhah MD, A Izadi MD, R Nazari MD H Hashemi MD, M Jabbarvand MD, H Hashemian MD

Mohammad Ali Javadi , MD. Sepehr Feizi , MD.

Dr. S.Chakravarty MBBS, MD MD

Megan Miller MD, Nancy Schindler MD, John Seal MD, Mark Russo MD

Ahmet ALANAY, MD Cagatay OZTURK, MD Meric ENERCAN, MD Ibrahim ORNEK, MD Mehmet TEZER, MD

Azmi HAMZAOGLU, MD Cagatay OZTURK, MD Ahmet ALANAY, MD Mehmet TEZER, MD Selhan KARADERELER, MD

Ali T. Taher, MD

Burcu Oktay MD , Sadık Ardıç MD, Hikmet Firat MD, Erdem Akbal MD, Ramazan Akdemir MD

HELVACIOGLU Firat , MD, SENCAN Sadik , MD, OGUZHAN Hasan, MD, YETER Celal, MD

Ali Khoynezhad, MD 1 , Carlos E. Donayre, MD 2 , Rodney A. White, MD 2

Roberto Hernandez-Irizarry, BS Benjamin Zendejas , MD, MSc Shahzad M. Ali, MD

Akiko Masai, MD, Tomoichiro Ogawa, MD Takuya Shiba, MD, Hiroshi Tsuneoka, MD

Osman Akdag, MD Mustafa Sutcu, MD Mustafa Keskin, MD

Gregg W. Stone, MD Manejeh Yaqub, MD; Poornima Sood, MD, MBA; Ali Rizvi, MD;

Daisuke Aizawa,MD Kazutaka Kamiya,MD Tetsuya Ikeda,MD Kimiya Shimizu,MD

Ali Ardalan MD, MPH, PhD student in Epidemiology

ali M. somily , MD

Mustafa Serinken MD, Cenker Eken MD, Kamil Tunay MD, Yalcin Golcuk MD