Outcomes of deep anterior lamellar keratoplasty following autologous simple limbal epithelial transplant in pediatric unilateral severe chemical injury

AIMS: To evaluate outcomes of deep anterior lamellar keratoplasty (DALK) in pediatric eyes with unilateral severe chemical injury which have undergone autologous simple limbal epithelial transplant (SLET). SETTINGS AND DESIGN: The study design was a retrospective case series. MATERIALS AND METHODS: This retrospective, case series of all children <16 years of age that have undergone DALK following autologous SLET procedure in unilateral severe chemical injury evaluates the outcomes and complications in the setting of a tertiary care center in North India. STATISTICAL ANALYSIS USED: Nonparametric data have been expressed as median (range), parametric qualitative data as percentage, and quantitative data as a mean ± standard deviation. Spearman's correlation coefficient is used for finding a correlation between variables. RESULTS: Eleven eyes of 11 children (5 male and 6 female) with a mean age of 8.9 ± 4.7 years underwent DALK following ocular surface reconstruction with autologous SLET earlier for unilateral severe chemical injury with limbal stem cell deficiency. Follow-up ranged from 6 to 18 months (13.00 ± 4.58 months) following DALK procedure. All patients with a minimal follow-up of 6 months were evaluated for visual outcomes. Visual acuity ranged from 0.3 to 3 logMAR units (0.6 ± 0.2 logMAR units). Complications were encountered in three patients. Anatomical success was seen in 72.72% patients and visual success was noted in 54.54% patients. CONCLUSIONS: DALK is a feasible option in children with severe unilateral chemical injury who have undergone ocular surface reconstruction with autologous SLET procedures.