BACKGROUND: Since 1991 homologous penetrating limbokeratoplasty has been performed in 32 patients with severe limbal stem cell insufficiency following chemical/thermal burns. The long-term results considering the effects of HLA matching are presented for the first time. PATIENTS: All patients received systemic cyclosporin A and/or mycophenolate mofetil in the postoperative course. In 9 patients grafts with 0-1 HLA mismatches in the HLA A, B and DR loci, in 6 patients grafts with 2-6 mismatches and in 17 patients untyped grafts were used. Long-term clear graft survival was estimated according to Kaplan and Meier. RESULTS: Five years postoperatively, 50% of the grafts with 0-1 mismatches, 32% of the grafts with 2-6 mismatches and 18% of the untyped grafts were centrally clear (log-rank-test, p>0.05). CONCLUSIONS: Although statistically not significant, HLA matched grafts seem to deliver better results than untyped grafts in penetrating limbokeratoplasty. Improvement of matching strategies and immunosuppression may possibly further improve current results.
BACKGROUND: Since 1991 homologous penetrating limbokeratoplasty has been performed in 32 patients with severe limbal stem cell insufficiency following chemical/thermal burns. The long-term results considering the effects of HLA matching are presented for the first time. PATIENTS: All patients received systemic cyclosporin A and/or mycophenolate mofetil in the postoperative course. In 9 patients grafts with 0-1 HLA mismatches in the HLA A, B and DR loci, in 6 patients grafts with 2-6 mismatches and in 17 patients untyped grafts were used. Long-term clear graft survival was estimated according to Kaplan and Meier. RESULTS: Five years postoperatively, 50% of the grafts with 0-1 mismatches, 32% of the grafts with 2-6 mismatches and 18% of the untyped grafts were centrally clear (log-rank-test, p>0.05). CONCLUSIONS: Although statistically not significant, HLA matched grafts seem to deliver better results than untyped grafts in penetrating limbokeratoplasty. Improvement of matching strategies and immunosuppression may possibly further improve current results.
Authors: P Wernet; G Kögler; J Enczmann; A Kuhröber; A J Knipper; W Bonte; T Reinhard; R Sundmacher Journal: Graefes Arch Clin Exp Ophthalmol Date: 1998-07 Impact factor: 3.117
Authors: Stefan J Lang; Philipp Eberwein; Helga Reinshagen; Thomas Reinhard; Rainer Sundmacher Journal: Medicine (Baltimore) Date: 2015-05 Impact factor: 1.889