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LETTER TO THE EDITOR
Year : 2019  |  Volume : 67  |  Issue : 8  |  Page : 1382-1383

Feasibility and outcome of simple limbal epithelial transplantation (SLET) in unilateral total limbal stem cell deficiency (LSCD) following chemical injury, in a semiurban location in Western India


1 Cornea and Anterior Segment Services, Drashti Nethralaya, Dahod, Gujarat; Eye Life; Netra Mandir, Mumbai, Maharashtra, India
2 Cornea and Anterior Segment Services, Drashti Nethralaya, Dahod, Gujarat, India

Date of Web Publication22-Jul-2019

Correspondence Address:
Dr. Sushmita G Shah
Eye Life, 204 Ram Krishna Chambers, Liking Road, Khar West, Mumbai – 52
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1697_18

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How to cite this article:
Shah SG, Shah SM, Agarwal J, Mulchandani A. Feasibility and outcome of simple limbal epithelial transplantation (SLET) in unilateral total limbal stem cell deficiency (LSCD) following chemical injury, in a semiurban location in Western India. Indian J Ophthalmol 2019;67:1382-3

How to cite this URL:
Shah SG, Shah SM, Agarwal J, Mulchandani A. Feasibility and outcome of simple limbal epithelial transplantation (SLET) in unilateral total limbal stem cell deficiency (LSCD) following chemical injury, in a semiurban location in Western India. Indian J Ophthalmol [serial online] 2019 [cited 2019 Aug 17];67:1382-3. Available from: http://www.ijo.in/text.asp?2019/67/8/1382/263118



Sir,

Simple limbal epithelial transplantation (SLET) was first described by Sangwan et al. as an innovative technique for the management of unilateral total limbal stem cell deficiency (LSCD).[1] Subsequently, its efficacy has been described by Vazirani et al. in a multicenter study conducted across advanced eye care centers in urban locations in India, United States, and Mexico.[2]

We describe the outcome and feasibility of performing SLET by a trained corneal surgeon in a semi-urban setting in western India. Patients with unilateral total LSCD following chemical injury with healthy fellow eye were included. Surgical technique as described by Sangwan et al. was followed.[1] Outcome measures were as follows: (i) Improvement in visual acuity, (ii) improvement in corneal clarity and LSCD, (iii) ease of performing SLET in a semi-urban setting.

Three patients, two males and one female with age range 13-16 years were included in the study. One patient had history of lime burn while two had exposure to unknown chemicals. At mean follow up of 4.33 months (range 2-6 months), two patients (66.6%) improved from preoperative visual acuity of <20/400 to 20/80 and 20/60, respectively. One patient remained at 20/400 which could be attributed to pre-existing amblyopia. Complete resolution of LSCD was noted in two patients (66.6%) while one patient had localized residual pannus of 1 clock hour.

Our results are comparable to that of the multicenter study.[2] As mentioned by Basu et al., the advantages of SLET include minimal surgical paraphernalia, logistical support, and training.[3] In our study, the procedures were easily performed by an experienced cornea specialist who had attended SLET workshops and had performed a few cases of SLET prior to this study. The other essential requirements include fresh frozen amniotic membrane and fibrin glue which can be made available even in semi-urban areas. SLET can thus be performed in hospitals located in such areas.

To conclude, this study establishes that SLET could be performed by a trained corneal surgeon even in semi-urban settings with useful outcomes.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sangwan VS, Basu S, MacNeil S, Balasubramanian D. Simple limbal epithelial transplantation (SLET): A novel surgical technique for the treatment of unilateral limbal stem cell deficiency. Br J Ophthalmol 2012;96:931-4.  Back to cited text no. 1
    
2.
Vazirani J, Ali MH, Sharma N, Gupta N, Mittal V, Atallah M, et al. Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency: Multicentre results. Br J Ophthalmol 2016;100:1416-20.  Back to cited text no. 2
    
3.
Basu S, Bahuguna C, Singh V. Simple limbal epithelial transplantation: Impactful innovation. Ind J Ophthalmol 2018;66:53-4.  Back to cited text no. 3
    




 

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