B

Host Eye

Donor Eye

Um bus

-Cornea

Donor tissue

Tri mmed limbal tissue

Donor Eye

-Cornea

Diseased host eye

Um bus

Donor tissue

Tri mmed limbal tissue

Corneal stroma exposed after removal of fibrovascular tissue

Application of amniotic membrane to reconstruct ocular surface

Host eye after corneal transplantation and suturing of limbal graft

FIGURE 4.11 Transplantation of allogeneic limbal segments to restore corneal epithelium. (A) The limbal tissue and, if necessary, the cornea, were removed from the donor eye. (B) The diseased fibrovascular tissue was removed from the host eye to expose the corneal stroma and a sheet of amniotic membrane was applied as a substrate for re-epithelialization and to reduce inflammation. The limbal graft was then sutured in around the rim of the eye. If the host stroma was diseased, it was removed and the donor corneal button transplanted as well. (C) Results of the operation in a 32 year old woman with Stevens-Johnson syndrome. Top, the opaque ocular surface. Middle, donor limbal tissue (arrow) sutured in place. Bottom, Seventeen months after surgery a large portion of the cornea is clear. Reproduced with permission from Tsubota et al., Treatment of severe ocular-surface disorders with corneal epithelial stem-cell transplantation. New Eng J Med 340:1697-1703. Copyright 1999, Massachusetts Medical Society.

Diseased host eye

Corneal stroma exposed after removal of fibrovascular tissue

Application of amniotic membrane to reconstruct ocular surface

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