Technique for Ocular Surface Reconstruction With Keratolimbal Allograft for Recurrent Symblepharon
Purpose
To describe a technique for recurrent symblepharon repair with ocular surface reconstruction using keratolimbal allograft tissue.
Methods
Seven eyes of seven patients with recurrent symblepharon causing restrictive diplopia in primary gaze were treated. Following meticulous symblephara lysis and scar tissue removal, keratolimbal allograft (KLAL) tissue was used to reconstruct the ocular surface and provide a spacer to prevent recurrent scarring. The primary outcome measures are symblepharon recurrence and diplopia in primary position. Secondary outcome measures include diplopia in cardinal directions of gaze.
Results
All seven eyes were free of symblepharon recurrence in areas reconstructed with KLAL sections. Mild recurrence of adhesions occurred only up to the edge of the KLAL graft, without violating the donor tissue. The diplopia in primary gaze was resolved and maintained in all cases with only mild recurrent diplopia in extreme lateral gaze.
Conclusion
Ocular surface reconstruction with KLAL is an effective procedure in patients with recurrent symblepharon. Donor KLAL is a robust tissue alternative to traditional amniotic membrane or conjunctival autografts for the treatment of recurrent symblepharon.