Ocular surface stem cell transplantation (OSST) patients should be closely monitored for rejection and compliance with immunosuppression.
Ocular surface stem cell transplantation (OSST) patients should be closely monitored for rejection and compliance with immunosuppression, claims a paper in the journal Cornea.
Dr A.Y. Ang et al., Cincinnati Eye Institute, Cincinnati, Ohio, USA, conducted a chart review of 222 eyes of 158 patients who underwent OSST at a single institution between 1998 and 2010. The group collected data on patient demographics, type of OSST procedure, duration of immunosuppression and rejection characteristics. The primary outcome measures were ocular surface stability and improvement in BCVA.
The most common indications for OSST were aniridia in 46.4% of patients, chemical/thermal injury in 22.1% and Stevens-Johnson syndrome in 12.2%. The most frequent procedures performed were keratolimbal allograft (KLAL) alone in 80.6% of patients and combined living-related conjunctival allograft (lr-CLAL)-KLAL in 11.3%.
Severe rejection was seen in 43 eyes, while low-grade rejection occurred in 26 eyes. At the final follow-up, 36.6% of eyes in the rejection group presented with a stable ocular surface, compared with 71.9% of eyes in the non-rejection group. Younger age, KLAL alone and noncompliance with immunosuppression were all factors that played a significant part in increasing the risk of rejection.
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