Simple Limbal Epithelial Transplantation (SLET) for chemical injury: a case report from National Eye Centre, Kaduna

Abstract

Chemical injury to the eye is a sight-threatening emergency that can result in limbal stem cell deficiency (LSCD), which may lead to persistent epithelial abnormalities, corneal opacity and eventual vision loss. Simple Limbal Epithelial Transplantation (SLET) has evolved as a successful, one-stage, minimally invasive surgical approach for restoring the ocular surface in LSCD. We report the case of a 21-year-old male who suffered a serious alkali burn to his left eye after being accidentally exposed to herbicide. Despite initial treatment with extensive irrigation, topical nonsteroidal anti-inflammatory drugs and antibiotics, the patient acquired chronic epithelial abnormalities and corneal conjunctivalization.

Following a diagnosis of unilateral LSCD, autologous SLET was conducted using about 2 × 2 mm limbal sample from the contralateral healthy eye, spread over an amniotic membrane put on the corneal surface with bandage contact lens. Topical antibiotics, corticosteroids and preservative-free lubricants were administered postoperatively. The patient was observed for the first three months. Within three weeks, the ocular surface had stabilized and epithelialized completely. There was no recurrent conjunctivalization or irritation. Best-corrected visual acuity had improved from counting fingers to 6/12 as at the first year post-SLET.

This case demonstrates the safety, ease of use and efficacy of SLET in recovering corneal epithelial integrity and visual function in young individuals with unilateral LSCD following chemical injury. Early referral and adequate surgical intervention are critical for the best results.