Autologous Glueless Simple Limbal Epithelial Transplantation For Unilateral Stem Cell Deficiency Utilizing Femtosecond Laser-Assisted Limbal Stem Cell Harvesting. The Report Of The First Three Clinical Cases

To evaluate the first clinical results of corneal surface reconstruction with the help of a femtosecond laser (FSL) – full FSL-assisted autologous glueless simple limbal epithelial transplantation (Full FSL G-SLET) for unilateral limbal stem cell deficiency (LSCD).

UCLA Department of Ophthalmology. Stein Eye Institute

S. Fyodorov Eye Microsurgery Institution

After chemical eye burns, three patients underwent Full FSL G-SLET procedures, including two critical laser-assisted steps: harvesting of the eight autologous limbal micrografts from the healthy eyes and placing them into laser-cut non-penetrating corneal tunnels performed on the affected eye.

The donor eyes recovered very quickly, and 3-4 weeks after surgery, a small scar in the limbal area formed with no adverse effects on visual acuity. Three patients had various rates of corneal reepithelialization of the recipient eyes: 1 month, 1.5 months and 4 months postoperatively. Complete corneal epithelialization was achieved in all the cases. The epithelial layer was stable for 12 months postoperatively, as confirmed by corneal staining with low-molecular-weight fluorescein and anterior segment OCT. Visual acuity improvement was observed in all three patients.

This is the first report of successful clinical use of FSL for autologous G-SLET surgical procedures when the laser was used not only to create corneal tunnels for autologous limbal micrograft fixation but also for their in vivo harvesting and fragmentation.