Autologous Glueless Simple Limbal Epithelial Transplantation for Unilateral Stem Cell Deficiency Using Femtosecond Laser-Assisted Limbal Stem Cell Harvesting: The Report of the First 3 Clinical Cases.

PURPOSE: To evaluate the first clinical results of corneal surface reconstruction with the help of a femtosecond laser (FSL)-full FSL-assisted autologous glueless simple limbal epithelial transplantation (Full FSL G-SLET) for unilateral limbal stem cell deficiency.

METHODS

After chemical eye burns, 3 patients underwent Full FSL G-SLET procedures, including 2 critical laser-assisted steps: harvesting of the 8 autologous limbal micrografts from the healthy eyes and placing them into laser-cut nonpenetrating corneal tunnels performed on the affected eye.

RESULTS

The donor eyes recovered very quickly, and 3 to 4 weeks after surgery, a small scar in the limbal area formed with no adverse effects on visual acuity. Three patients had various rates of corneal reepithelization of the recipient eyes: 1 month, 1.5 months, and 4 months postoperatively. Complete corneal epithelialization was achieved in all cases. The epithelial layer was stable for 12 months postoperatively, as confirmed by corneal staining with low-molecular-weight fluorescein and anterior segment optical coherence tomography. Visual acuity improvement was observed in all 3 patients.

CONCLUSIONS

This is the first report of successful clinical use of FSL for autologous G-SLET surgical procedures when the laser was used not only to create corneal tunnels for autologous limbal micrograft fixation but also for their in vivo harvesting and fragmentation.