SIMPLE LIMBAL EPITHELIAL TRANSPLANTATION (SLET) FOR LIMBAL STEM CELL DEFICIENCY: A CASE SERIES

To report preliminary outcomes of simple limbal epithelial transplantation (SLET) in patients with chemical burn-induced limbal stem cell deficiency (LSCD) and evaluate its potential as an alternative to cultivated limbal epithelial transplantation (CLET). 

 We retrospectively reviewed three cases of total LSCD caused by chemical burns—two patients had unilateral involvement, and one had bilateral disease.

 All underwent autologous SLET by the same surgeon (CK) at our tertiary center. Two patients were followed for at least 6 months; the third was 3 weeks post-op at reporting. Outcomes included ocular surface stability, epithelialization, visual acuity, and complications. Epithelial healing was documented via anterior segment photography (Rodenstock RSL 2600 Digital). Corneal thickness and topography were assessed with anterior segment OCT (CASIA2) and corneal topography (Oculus Pentacam) when feasible. 

Complete epithelialization was achieved in three patients within 4 weeks, and ocular surface stability was maintained in all patients. Two patients improved best corrected visual acuity (BCVA) within 1 month; one with 3 weeks follow-up remained stable. One patient required penetrating keratoplasty 6 weeks post-SLET due to traumatic corneal perforation. Compared to prior experience with CLET (Holoclar®), SLET showed promising outcomes, particularly in accessibility and logistics. 

SLET is a viable, cost-effective alternative to CLET when eligibility or availability is limited, offering encouraging early results in chemical burn-induced LSCD.