Combined HLA matched limbal stem cells allograft with amniotic membrane transplantation as a prophylactic surgical procedure to prevent corneal graft rejection after penetrating keratoplasty: case report

Abstract

Purpose. To determine if the use of combined HLA matched limbal stem cells allograft  with  amniotic  membrane  transplantation  (AMT)  is  a  safe  and  effective  prophylactic  surgical procedure to prevent corneal graft after penetrating keratoplasty (PK).Methods.  We  report  the  case  of  a  17  years  old  patient  with  a  history  of  congenital  glaucoma, trabeculectomy and multiple corneal graft rejections, presenting total limbal  cell deficiency. To reduce the possibility of graft rejection in the left eye after a new PK,  a two step procedure was performed. At first the patient underwent a combined HLA  matched limbal stem cells allograft (LAT) and AMT and then, 10 months later, a new  PK.Results. During 12 months of follow-up, the corneal graft remained stable and smooth,  with no sign of graft rejection.Conclusions. In our patient, the prophylactic use of LAT from HLA-matched donors  and AMT before PK, may result in a better prognosis of corneal graft survival.