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The Official Scientific Journal of Delhi Ophthalmological Society
Conjunctivolimbal Autograft versus Cadaveric Keratolimbal Allograft in Ocular Surface Disorder: A Comparison
Jaya Kaushik1-2, Jitendra Kumar Singh Parihar1, Vaibhav Kumar Jain3, Vijay Mathur1 
1Department of Ophthalmology, Army Hospital Research and Referral, Delhi Cantt, India
2Command Hospital Chandimandir, Panchkula, Haryana
3Department of Ophthalmology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
Corresponding Author:
Vaibhav Kumar Jain 
MD
Assistant Professor,
Department of Ophthalmology
Sanjay Gandhi Post Graduate Institute 
of Medical Sciences, Lucknow, India
 Email id: vaibhav.jainaiims@gmail.com
Published Online: 30-JUL-2018
DOI: http://dx.doi.org/10.7869/djo.371
Abstract
Purpose:- To compare the outcomes of conjunctivolimbal autograft (CLAU) and cadaveric keratolimbal allograft (KLAL) in limbal stem cell deficiency (LSCD) with ocular surface disorders.
Materials & Methods:- In this prospective randomized clinical study, 50 eyes of 50 patients with unilateral LSCD were divided into two groups based on the surgical intervention. Group 1 patients (25 eyes) had CLAU, whereas group 2 patients (25 eyes) underwent cadaveric KLAL. The outcome measures were functional vision (best corrected visual acuity = 6/60), gain of = 2 lines of Snellen’s visual acuity, corneal neovascularisation, visually significant corneal opacity (Iris details poorly visible), fluorescein stain, Schirmer’s = 10 mm, tear break-up time (TBUT) = 10 seconds. 
Results:- At 1 year of follow-up, both CLAU and cadaveric KLAL were comparable in terms of visual gain of = 2 lines, functional vision, corneal neovascularisation, Schirmer’s = 10 mm, TBUT = 10 seconds. The epithelisation was found to be early with CLAU as compared with cadaveric KLAL (p = 0.032). Patients with cadaveric KLAL had more recurrent epithelial defects (40%) as compared to CLAU (24%). 
Conclusions:- Both procedures are effective in terms of visual gain and ocular surface restoration. Cadaveric KLAL seems to be a good alternative whenever CLAU is not possible.
Keywords : limbal stem cell deficiency; ocular surface disorder; conjunctivolimbal autograft; keratolimbal allograft
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