A Patient Who Suffered a Chemical Burn in the Left Eye 2 Years Ago Complains of Persistent Blurry Vision and Photophobia. There Is Corneal Neovascularization and Conjunctivalization Extending 5 mm From the Limbus. Do They Need Limbal Stem Cell Transplantation?

Limbal stem cell deficiency (LSCD) is a condition where the cornea is unable to maintain (regenerate) the corneal epithelium due to an inadequate number/function of the limbal epithelial stem cells. Patients may complain of redness, irritation, photophobia, and decreased vision. Early slit-lamp findings include loss of the palisades of Vogt, late staining of the epithelium with fluorescein, corneal neovascularization, and the development of peripheral pannus. Over time, corneal findings may progress to involve the central cornea. The epithelium becomes irregular and hazy, and persistent epithelial defects may lead to stromal scarring. Conjunctivalization results from invasion of the corneal surface by conjunctival tissue due to the absence of the limbal barrier.