Optimizing outcomes in keratolimbal allograft for limbal stem cell deficiency.

PURPOSE OF REVIEW: The present review will focus on recent advancements affecting outcomes in keratolimbal allograft (KLAL).

RECENT FINDINGS: Recent advancements involve methodologies for donor selection, eye bank preparation of KLAL tissue, risk stratification, and immunosuppression to prevent both early and late immunologic rejection.

SUMMARY: Keratolimbal allograft (KLAL) remains an essential technique for addressing severe limbal stem cell deficiency in patients without access to a suitable living donor eye (whether autologous or allogeneic). While outcomes of KLAL have traditionally lagged behind those of living-related limbal allografts, recent advancement in KLAL techniques may reduce this gap.