Surgeons detail steps for simple limbal epithelial transplantation

In 1964, Jose Barraquer described a surgical technique for limbal stem cell deficiency, or LSCD. The paramount finding of extensive LSCD is conjunctival transgression across the corneal-conjunctival border and the limbus and onto the cornea, resulting in vascularization, chronic inflammation, persistent epithelial defects and recurrent erosions, which uninterrupted can progress to corneal opacity and transform to a skin-like corneal surface with corneal blindness. These border “policemen” between the corneal and conjunctival territories are largely accepted as the limbal stem cells that are believed to be housed within the radial fibrovascular ridges, the limbal palisades of Vogt.With all the global research in this field, there is no definite marker at the present time for limbal stem cells. Compromise of limbal stem cells up to a certain extent, namely, partial or sectoral LSCD, can be corrected by the remaining stem cells. However, more extensive or total LSCD results in the inevitable transformation of the clear cornea toward an opaque cornea and potential loss of vision.