The long-term safety of donor eye for 180 degrees limbal transplantation

Background Little information is currently available on the long-term safety of eyes following limbal tissue donation. We have therefore evaluated long-term refractive changes, corneal surface stability, and visual outcome following limbal tissue donation of 180 degrees with permanent amniotic membrane transplantation (AMT). Methods Four healthy eyes of four patients underwent limbal keratectomy involving half of the limbal circumference (half limbal) for the purpose of limbal donation with permanent AMT. The best corrected visual acuity (BCVA), astigmatic changes by manifest refraction, and corneal surface changes as assessed by slit-lamp examination and by impression cytology were evaluated. Results The mean follow-up period was 20.8 months (range: 19-24 months). BCVA remained unchanged in three eyes (75%), but eye one showed a BCVA decrease of two lines due to newly developed filamentary keratitis caused by Sjogren's syndrome. The average astigmatism change was an increase of 0.31 diopters. Conjunctival invasion toward the center beyond the edge of the keratectomy did not occur in any of the eyes, as assessed by impression cytology. Partial conjunctivalization within 2 h on keratectomy sites covered with amniotic membrane developed in three eyes (75%). Conclusions Limbal donation of 180 degrees with permanent AMT seems to be a safe procedure, demonstrating stable astigmatism and an intact corneal surface for at least 1.5 years following the initial donation.