To evaluate the results of one 60-degree block conjunctival limbal autograft surgery in patients with unilateral total limbal stem cell deficiency

Five eyes of 5 patients were included. All patients had a history of chronic total unilateral LSCD due to a chemical injury. Two patients underwent one 60-degree block CLAU with amniotic membrane transplantation, two patients had been complicated by inadvertent trephination of one block of a previous successful two-block CLAU at the time of subsequent corneal transplantation, and the last patient had been complicated by one CLAU segment loss due to loose sutures and premature suture removal. Corneal epithelial healing was evaluated

All patients developed persistant epithelial defect refractory to conservative medical management. In two cases with inadvertent one segment trephination, despite both conservative and surgical management, corneal perforation occurred. Tectonic keratoplasty was performed in both eyes. Persistant epithelial defect occurred over both grafts, which healed with large sectoral vascularized corneal pannus in one eye and with mucous membrane grafting in the other eye. In the last patient with lost lenticule, cultivated limbal epithelial transplantation was performed to treat the epithelial defect

One-block limbal transplantation during conjunctival limbal autograft surgery is not sufficient for eye with total unilateral LSCD