Alloslet With Keratoplasty – Saving The Surface In Xeroderma Pigmentosa

To report addressing of limbal stem cell deficiency (LSCD) due to Xeroderma Pigmentosa (XP) while doing penetrating keratoplasty. Eyes of XP patients are poor candidates for corneal surgery leading to epithelial irregularity and stromal scarring, resulting in visual loss and graft failure, which is tackled by this combined approach.

Department of Cornea and Refractive Surgery

Sankara Nethralaya,

Medical Research Foundation,

Chennai, Tamil Nadu – 600006, India.

Our single-eyed XP patient with two failed grafts with epithelial roughening, stromal scarring and 360 LSCD with limbal vascularization, underwent alloSLET (allogenic Simple Limbal Epithelial Transplant) alongside her third keratoplasty, to prevent post-operative epithelial failure. She was treated with topical and systemic immunosuppression.

Post-operatively, the SLET bits were found to be well integrated with an intact ocular surface and clear graft at 4 months. Thus, combining the two procedures gave good anatomical and functional outcome in our single-eyed patient.

Ours may be the first case report on combining alloSLET with keratoplasty for re-epithelization in an XP patient, with multiple graft failures in the past.