early results of autologous cultivated limbal stem cell transplantation in total limbal stem cell deficiency

purpose: to report the early results of transplantation of autologous limbal stem cell cultivated on amniotic membrane in total limbal stem cell deficiency. methods: four eye of 4 patients with total unilateral stem cell deficiency secondary to severe chemical or thermal burn were included. stem cell deficiency was confirmed with impression cytology in all cases. under topical anesthesia, a small limbal sector (1´1 mm) was removed from the sound eye and cultivated on amniotic membrane. cell expansions were transplanted to the affected eye 2 weeks later. patients were regularly followed up. at each follow-up visit, a complete eye examination with special attention to recurrence or regression of vascularization, corneal opacification, and healing of epithelial defect was performed. digital imaging was performed at each follow-up visit. impression cytology was repeated in all cases after surgery. results: the patients were followed for 5-13 months. decrease in corneal opacification and vascularization was obvious in 3 cases, in which the surface of the cornea was covered with corneal epithelium. sectoral conjunctivalization was evident in these 3 cases, but their corneas were ready for corneal transplantation. the procedure failed in one case with total corneal conjunctivalization. visual acuity improved in all cases. conclusion: autologous cultivated stem cell transplantation on amniotic membrane seems to be an effective way for stem cell transplantation. more definite judgment needs longer follow-up together with long-term results of corneal transplantation in these patients.