The key difference between keratolimbal allograft and autologous graft is that keratolimbal allograft utilizes cadaveric limbal stem cells while autologous graft utilizes limbal stem cells from the healthy eye of the person undergoing surgery.
Corneal limbus forms the border between the transparent cornea and opaque sclera. Limbus constitutes of corneal epithelial stem cells, which are the ultimate source of transparent corneal epithelium. Therefore, limbal epithelial stem cells maintain a healthy functional corneal epithelium.
CONTENTS
1. Overview and Key Difference
2. What is Limbal Stem Cell Deficiency
3. What is Keratolimbal Allograft
4. What is Autologous Graft
5. Similarities Between Keratolimbal Allograft and Autologous Graft
6. Side by Side Comparison – Keratolimbal Allograft vs Autologous Graft in Tabular Form
7. Summary
What is Limbal Stem Cell Deficiency?
Limbal stem cell deficiency is a disease condition arising due to destruction of the limbal epithelial stem cells. It can mainly occur due to chemical injury or impairment of the development. Limbal stem cell deficiency is responsible for decreased vision, pain and impaired quality of life. Limbal stem cell transplantation is the main surgical treatment for limbal stem cell deficiency. There are several limbal stem cell transplantation procedures. Keratolimbal allograft and autologous graft are two techniques are two among them.
What is Keratolimbal Allograft?
Keratolimbal allograft is a technique that uses cadaveric limbal stem cells to treat a patient with a limbal stem cell deficiency. This surgery is done when there is no available or willing relative to donate limbal stem cells for stem cell transplantation. Hence, this procedure utilizes the allogenic tissue for the transplantation. Keratolimbal allograft is a promising surgery for bilateral or total stem cell deficiency. Its’ reported success rate is around 73%.
Figure 01: Limbal Stem Cell Deficiency
After the keratolimbal allograft, the postoperative management of the patient is needed since it has a higher risk of rejection. This is because the limbal area is highly vascularized, and is more accessible to the immune system. Obtaining an appropriate tissue is crucial for the success of the procedure. However, in addition to immunologic rejection, there can be graft related complications and chronic ocular surface exposure.
What is Autologous Graft?
Autologous graft is another procedure of stem cell transplantation. Autologous limbal stem cell transplantation especially uses limbal stem cells from the patient’s healthy eye. Therefore, it is necessary to harvest stem cells from the patient itself. After harvesting, the cells are cultured and transplanted. Therefore, it is a type of autologous ex-vivo cultivated limbal epithelial transplantation.
Since autologous graft utilizes a person’s own limbal stem cells, this technique shows faster epithelialization and less inflammation. Another advantage is that it needs less amount of tissue in comparison to allogeneic transplantation. Moreover, the success rate of autologous graft is higher than that of the allogeneic graft. Autologous graft is more suitable for unilateral limbal stem cell deficiency.
What are the Similarities Between Keratolimbal Allograft and Autologous Graft?
- Keratolimbal allograft and autologous graft are two techniques of limbal stem cell transplantation.
- Both procedures are able to restore a stable ocular surface.
What is the Difference Between Keratolimbal Allograft and Autologous Graft?
Keratolimbal allograft is a limbal stem cell transplantation procedure which utilizes cadaveric limbal stem cells for the reconstruction of the ocular surface while autologous graft is a stem cell transplantation technique which utilizes limbal stem cells from the healthy eye of a person. So, this is the key difference between keratolimbal allograft and autologous graft. Immunogenic rejection is low in autologous graft than in keratolimbal allograft. Another difference between keratolimbal allograft and autologous graft is that the success rate of autologous graft is higher than in keratolimbal allograft.
The below infographic summarizes the difference between keratolimbal allograft and autologous graft.
Summary – Keratolimbal Allograft vs Autologous Graft
Keratolimbal allograft and autologous graft are two surgical procedures of limbal stem cell transplantation. Keratolimbal allograft uses cadaveric limbal stem cells or allogenic tissue from a donor while autologous graft utilizes the person’s own limbal stem cells. This is the key difference between keratolimbal allograft and autologous graft. Autologous graft is done for unilateral limbal stem cell deficiency while keratolimbal allograft is done for bilateral or total limbal stem cell deficiency. The success rate of autologous graft is higher in comparison to keratolimbal allograft.
Reference:
1. Krakauer, et al. “Adverse Effects of Systemic Immunosuppression in Keratolimbal Allograft.” Journal of Ophthalmology, Hindawi, 28 Feb. 2012, Available here.
2. Atallah, Marwan Raymond, et al. “Limbal Stem Cell Transplantation: Current Perspectives.” Clinical Ophthalmology (Auckland, N.Z.), Dove Medical Press, 1 Apr. 2016, Available here.
Image Courtesy:
1. “Chemical burn injury” By Secker, G.A., and Daniels, J.T., Limbal epithelial stem cells of the cornea (June 30, 2009), StemBook, ed. The Stem Cell Research Community, StemBook (CC BY 3.0) via Commons Wikimedia