Glueless Simple Limbal Epithelial Transplantation: The Report of the First 2 Cases

Purpose: To assess the anatomic and visual results of the modified glueless simple limbal epithelial transplantation (G-SLET) in the treatment of unilateral limbal stem cell deficiency (LSCD). Methods: This is a retrospective analysis of 2 patients who received G-SLET for corneal reepithelization after unilateral eye burn. After the recipient bed preparation on the eye with LSCD, radial symmetrical superficial incisions were applied to the corneal periphery. Next, short (1 mm) slightly oblique or horizontal tunnels were formed in every incision. The precut limbal pieces from the healthy eye were inserted into the tunnels with a scleral portion forward. At the end of surgery, the amniotic membrane was sutured to the sclera outside the corneal limbus with a single running suture. Results: Slit lamp examination in the early postoperative period revealed that transplanted limbal pieces remained in place and were visible through the semitransparent amniotic membrane. The donor's eye had a small scar and light subconjunctival hemorrhage. Early and late postoperative periods were uneventful. Twelve months after surgery, the LSCD-affected cornea was entirely covered with tight and semitransparent epithelium. The donor's eye exhibited a small scar on the site of the biopsy. Visual improvement was achieved in case 2, but the vision did not improve due to the presence of a mature cataract in case 1. Conclusions: Modified G-SLET technique could be an option for LSCD treatment in patients with unilateral eye disease in cases when fibrin glue is not available for the surgeon.