A ytematic Literature Review of urgical Intervention for Limbal tem Cell Deficiency in Human Original Reearch Article

Purpoe To evaluate the relative benefit and to identify any advere effect of urgical intervention for limbal tem cell deficiency (LCD). Deign ytematic literature review. Method We earched the following electronic databae from January 1, 1989 through eptember 30, 2006: MEDLINE, EMBAE, cience citation index, BIOI, and the Cochrane Library. In addition, reference lit were canned to identify any additional report. The quality of publihed report wa aeed uing tandard method. The main outcome meaure wa improvement in viion of at leat two nellen line of bet-corrected viual acuity (BCVA). Data on advere outcome alo were collected. Reult Twenty-ix tudie met the incluion criteria. There were no randomized controlled tudie. All 26 tudie were either propective or retropective cae erie. For bilateral evere LCD, keratolimbal allograft wa the mot common intervention with ytemic immunouppreion. Other intervention included eccentric penetrating keratolimbal allograft and cultivated autologou oral mucoal epithelial graft. An improvement in BCVA of two line or more wa reported in 31% to 67% of eye. For unilateral evere LCD, the mot common urgical intervention wa contralateral conjunctival limbal autograft, with 35% to 88% of eye gaining an improvement in BCVA of two line or more. The only tudy evaluating partial LCD howed an improvement in BCVA of two line or more in 39% of eye. Concluion tudie to date have not provided trong evidence to guide clinical practice on which urgery i mot beneficial to treat variou type of LCD. tandardized data collection in a multicenter LCD regiter i uggeted.