Name of the Procedure:

Ocular Surface Reconstruction; Limbal Stem Cell Allograft (e.g., Cadaveric or Living Donor).

Summary

This procedure involves transplanting stem cells from a donor's eye to the patient's eye to repair and regenerate the surface of the eye, particularly the cornea, which may be damaged due to disease or injury.

Purpose

The medical condition: Limbal stem cell deficiency (LSCD), which can result in pain, vision loss, and chronic eye irritation. Goals: To restore a healthy ocular surface, improve vision, and reduce discomfort.

Indications

• Severe corneal burns or injury
• Stevens-Johnson syndrome
• Aniridia (absence of the iris)
• Pterygium (benign growth on the eye)
• Genetic or acquired conditions causing LSCD

Preparation

• No food or drink for 6-8 hours before the procedure.
• Review and potentially adjust current medications with the doctor.
• Undergo comprehensive eye examination and specialized imaging tests.

Procedure Description

1. Administration of local or general anesthesia.
2. Removal of damaged corneal tissue from the patient’s eye.
3. Harvesting of limbal stem cells from a cadaveric or living donor.
4. Transplantation of these stem cells onto the patient’s cornea using microsurgical techniques.
5. Application of a protective contact lens to aid healing.

Duration

Approximately 1 to 2 hours.

Setting

Typically performed in a hospital or specialized surgical center with ophthalmologic facilities.

Personnel

• Ophthalmic surgeon
• Surgical nurses
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection
• Rejection of the transplant
• Inflammation
• Scarring
• Vision disturbances Complications are usually managed with medications and careful follow-up.

Benefits

• Improved corneal surface health
• Better vision clarity
• Reduced eye discomfort
• Enhanced quality of life Benefits can often be noticed within a few weeks.

Recovery

• Use of prescribed antibiotic and anti-inflammatory eyedrops.
• Avoid rubbing or applying pressure to the eye.
• Follow-up appointments to monitor healing.
• Recovery can take several weeks to months, with restrictions on certain activities like swimming and strenuous exercise.

Alternatives

• Auto-limbal stem cell transplant (using patient’s own cells if available)
• Amniotic membrane transplant
• Corneal transplantation
• Pros and cons: These alternatives may have varied success rates and availability, with different recovery times and risks.

Patient Experience

During: The procedure is minimally discomforting due to anesthesia. After: Patients may experience mild discomfort, itching, or irritation. Adequate pain management and comfort measures are provided to alleviate any discomfort.