Table 3.
Comparison of the surgical options for limbal stem cell deficiency (LSCD).
| Unilateral LSCD | Bilateral LSCD | Systemic immune suppression | Disadvantage | Success rate | |
|---|---|---|---|---|---|
| CLAU | Indicated | NA | Not required | Two pieces of 2-2.5-clock-hour grafts needed; may deplete donor LESCs |
80%-100% |
| CLET | Indicated | Allo-CLET | Not required for auto; Required for allo | Expensive; Two-step surgery; Special requirements (feeder cells, special culture systems, a carrier) |
70%-77% |
| SLET | Indicated | Allo-SLET | Not required for auto; required for allo | Results less satisfactory when combined with keratoplasty | 50%-100% |
| KLAL | NA | Indicated | Always required | Requires cadaveric tissue or living donor Concerns about disease transmission Side effects from systemic immunosuppression Immune-rejection remains a challenge |
33%-77% |
| CLAL | NA | Indicated | Always required |
CLAU: conjunctival limbal autograft, CLET: cultivated limbal epithelial transplantation, SLET: simple limbal epithelial transplantation, KLAL: keratolimbal allograft, CLAL: conjunctival limbal allograft, LESCs: limbal epithelial stem cells.