Conjunctival limbal autografting (CLAU) combined with customised simple limbal epithelial transplantation (SLET) in a severe corneal chemical burn: Case report

PURPOSE: The most common cause of severe limbal stem cell deficiency (LSCD) is chemical injury. We report a case of severe unilateral alkali injury complicated by total LSCD, treated with customized Simple limbal epithelial transplantation (SLET) combined with conjunctival-limbal autografting (CLAU). OBSERVATION: A 23-year-old female sustained a severe unilateral alkali chemical injury, resulting in total LSCD, treated with customized SLET combined with CLAU. We used two autologous limbal biopsies harvested from the fellow eye. One was used for CLAU and the second was split into multiple pieces, and was glued to bare stroma following resection of the corneal pannus. A stable ocular surface was achieved, and the donor eye remained healthy. Visual acuity improved from hand motion initially, to 20/20 over one year post-operatively. CONCLUSION AND IMPORTANCE: This case report demonstrates the efficacy and safety of customized SLET with supplemental CLAU to treat total LSCD in severe ocular burns.