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Simple Limbal Epithelial Transplantation

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Modern Keratoplasty

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

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Abstract

Several techniques have been devised for the management of limbal stem cell deficiency (LSCD). Of these, simple limbal epithelial transplantation (SLET) is a novel technique aimed at restoring the avascular corneal epithelium. This procedure has several advantages, which include its simple single-staged technique and the independence of sophisticated equipment or laboratory support. SLET can be autologous or allogeneic in unilateral or bilateral cases, respectively. Both procedures have stable long-term outcomes and result in improved visual function secondary to remodeling of the underlying stromal scars. These outcomes can be ensured with proper case selection, and eyes with established LSCD, wet ocular surfaces, minimal adnexal, and corneal stromal involvement are ideal candidates for the same. Most common complications of SLET include primary failure, focal recurrences, and rejection. Risk factors for the same include inadequate address of concurrent symblephara, performing simultaneous keratoplasties, etc. A stepwise approach that addresses these issues in the correct sequence can prevent these complications and ensure predictable outcomes. This chapter will discuss the indications, preoperative considerations, surgical technique, postoperative management, and complications of SLET. This will provide the reader with a useful manual to understand the nuances of SLET, which will help adopt this technique for the management of LSCD.

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Authors and Affiliations

  1. Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Vijayawada, India

    Anahita Kate

  2. Shantilal Shanghvi Cornea Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India

    Sayan Basu

  3. Center for Ocular Regeneration (CORE), LV Prasad Eye Institute, Hyderabad, Telangana, India

    Sayan Basu

  4. Prof. Brien Holden Eye Research Centre, Champalimaud Translational Centre for Eye Research, LV Prasad Eye Institute, Hyderabad, India

    Sayan Basu

Authors
  1. Anahita Kate
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  2. Sayan Basu
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Correspondence to Sayan Basu .

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Editors and Affiliations

  1. Vissum Miranza, Miguel Hernández University, Alicante, Spain

    Jorge L. Alió

  2. Vissum-Instituto Oftalmologico de Alica, Miguel Hernandez University, Alicante, Alicante, Spain

    Jorge L. Alió del Barrio

Electronic Supplementary Material

This video details the stepwise surgical technique of autologous simple limbal epithelial transplantation. Harvesting of the limbal biopsy from the contralateral eye has also been depicted (MP4 128817 kb)

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Kate, A., Basu, S. (2023). Simple Limbal Epithelial Transplantation. In: Alió, J.L., del Barrio, J.L.A. (eds) Modern Keratoplasty. Essentials in Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-031-32408-6_13

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  • DOI: https://doi.org/10.1007/978-3-031-32408-6_13

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