Modified Allogenic Simple Limbal Epithelial Transplantation Followed by Keratoplasty as Treatment for Total Limbal Stem Cell Deficiency

Abstract

ABSTRACTPurpose: To describe a modified allogenic simple limbal epithelial transplant (SLET) technique with large donor tissue explants followed by keratoplasty.Methods: A 69-year-old with conjunctival melanoma on her left eye developed total limbal stem cell deficiency (LSCD) after multiple cycles of topical mitomycin. She also had herpes stromal keratitis while on treatment with mitomycin. She underwent modified allogenic SLET with large donor limbal tissue explants glued on the cornea directly and the amniotic membrane placed over the limbal explants.Results: Unfortunately she had recurrence of herpes simplex keratitis that caused worsening of stromal scarring and neovascularization. She underwent penetrating keratoplasty to improve vision. There were no postoperative complications and the corneal graft remains transparent 11 months after penetrating keratoplasty with 6/12 best-corrected visual acuity.Conclusions: Modified SLET with large donor limbal explants followed by keratoplasty is an effective approach to restore corneal transparency in cases of total LSCD.