Table 1.
Advantages, disadvantages, and complications of limbal stem cell transplantation techniques (CLAU: conjunctival limbal autograft, CLET: cultivated limbal epithelial transplantation, SLET: simple limbal epithelial transplantation, KLAL: kerato-limbal allograft, Ir-CLAL: living-related conjunctival limbal allograft, COMET: cultivated oral mucosal epithelial transplantation, PED: persistent epithelial defect, LSCD: limbal stem cell deficiency).
| Technique | Reference | Advantages | Disadvantages | Complications | |
|---|---|---|---|---|---|
| CLAU | [60,61,62] | -Acceptable outcomes -Application of conjunctival patch in ocular surface reconstruction |
Risk of iatrogenic LSCD | -Delayed epithelial healing -PED -Corneal perforation -Progressive conjunctival ingrowth |
|
| CLET | [63,64,65] | -Acceptable outcomes -Requirement of small donor tissue |
-Expense -Technical difficulties -Risk of prion disease transmission via animal product usage during culture |
-Postoperative hemorrhage under the graft -Infection -PED -Corneal perforation |
|
| SLET | [51,66] | -Acceptable outcomes -Requirement of small donor tissue |
-Risk of donor tissue loss | -Focal recurrence of LSCD -Progressive conjunctivalization and symblepharon -Keratitis -PED |
|
| COMET | [67,68] | Applicable in bilateral cases | -Peripheral corneal neovascularization -Suboptimal visual outcomes |
-PED -Corneal perforation -Glaucoma -Infection |
|
| Limbal allografts | lr-CLAL | [54,63] | -Applicable in bilateral cases -Utilizes a large conjunctival patch, which can be used in ocular surface reconstruction |
-Requirement of immunosuppression regimen -Delayed epithelialization -Limited long-term success |
-Rejection -Glaucoma -PED -Corneal melting and perforation -Graft-related issues -Infection -Posterior segment complications such as retinal detachment, vitreous hemorrhage, and cystoid macular edema |
| KLAL | [63,69,70] | -Applicable in bilateral cases -Providing a larger number of LESCs compared to lr-CLAL |
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