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Objectives: To evaluate the clinical characteristics and treatment strategies of limbal stem cell deficiency (LSCD) patients managed with medical therapy. Materials and Methods: The study included 29 eyes of 21 patients with LSCD who were managed medically at Ege University Faculty of Medicine, Department of Ophthalmology between May 2013 and May 2023. LSCD stages before and after medical treatment were recorded according to the LSCD staging system published by the International LSCD Working Group. The medical records of patients showing improvement in LSCD stage with medical treatment without surgical intervention were evaluated. Results: The mean age was 35.5±23.8 years (range, 5-71 years) with a male-to-female ratio of 6:15. The primary etiology of LSCD was ocular rosacea in 12 patients (57.1%), marginal keratitis in the setting of blepharitis in 8 patients (38.1%), and topical medication toxicity in 1 patient (4.8%). The mean baseline best corrected visual acuity (BCVA) was 0.25±0.26 logarithm of the minimum angle of resolution (logMAR) (range, 0-1 logMAR). Pre-treatment LSCD stage was stage 1A in 5 eyes (17.2%), stage 1B in 12 eyes (41.4%), stage 1C in 4 eyes (13.8%), stage 2A in 4 eyes (13.8%), and stage 2B in 4 eyes (13.8%). Complete regression of LSCD was achieved in 6 eyes (20.7%) with medical treatment addressing the primary etiology. In the remaining eyes, after medical treatment, the severity of LSCD decreased below the surgical threshold, which is considered stage 2B. The mean final BCVA was 0.07±0.1 logMAR (range, 0-0.4 logMAR). Conclusion: This study highlights that LSCD can be completely or partially reversible with appropriate management, especially in cases with underlying limbal niche dysfunction, where inflammation plays a significant role. Although limbal stem cell transplantation is considered the main treatment approach for LSCD, localized and early-stage LSCD can be effectively managed medically without the need for surgical intervention. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to evaluate any conjunctival metaplastic changes by impression cytology in patients who underwent topical 1% voriconazole treatment for severe fungal keratitis. Materials and Methods: The study was conducted at Ege University Faculty of Medicine, Departments of Ophthalmology and Medical Pathology. Patients who were treated with 1% topical voriconazole for fungal keratitis for at least 3 months were included. The used topical voriconazole treatment was initiated as one drop every hour and was tapered according to clinical improvement in all patients. Treatment was continued 4 times a day for at least 3 months. Impression cytology samples were collected at least 3 months after cessation of topical voriconazole from the affected eyes and from the fellow eyes as a control group. Collected specimens were transferred to the pathology department for evaluation and grading (Nelson's grading system). Results: The mean age of the patients was 57.68±17.32 years (range, 22-87 years). The impression cytology grade of the inferior bulbar conjunctiva was 1.73±0.77 (range, 0-3) in the study group and 1.19±0.98 (range, 0-3) in the control group (p=0.03). The impression cytology grade of the temporal bulbar conjunctiva was 1.69±0.73 (range, 0-3) in the study group and 1.15±0.88 (range, 0-3) in the control group (p=0.02). The impression cytology grades of the nasal and superior bulbar conjunctiva did not differ statistically (p values 0.13 and 0.17, respectively). Conclusion: Topical voriconazole is an effective broad-spectrum antifungal drug, but it induces conjunctival squamous metaplasia. Clinicians should be aware of this possible side effect of topical voriconazole and should carefully evaluate the conjunctiva of treated patients at each visit to detect possible metaplastic changes. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the demographic data, ocular and systemic findings, clinical management, and outcomes of patients with ocular cicatricial pemphigoid (OCP). Materials and Methods: The medical records of 11 patients diagnosed as having OCP in the ophthalmology department of Ege University between 2008 and 2021 were evaluated retrospectively. Results: The patients' mean follow-up time was 14±5.76 months. All eyes (100%) had conjunctival involvement and 18 (81.81%) had corneal involvement. According to the Tauber staging system, 7 (31.81%), 8 (36.36%), and 7 (31.81%) of the eyes were stage 2, 3, and 4, respectively. The diagnosis was confirmed in 6 (66.66%) of 9 patients who underwent biopsy. Amniotic membrane transplantation was performed in 7 eyes, entropion surgery in 2 eyes, and electrocauterization for trichiasis in 5 eyes. Systemic involvement was observed in 45.45% (5/11) of patients, most commonly oral mucosal involvement (18.18%). Review of medical records showed that alkylating agents, steroids, and dapsone were used in patients treated before 2020. Mycophenolate mofetil was preferred to be used in combination with corticosteroids. Although treatment responses before mycophenolate mofetil usage could not be evaluated well because of loss to follow-up, 4 (66.66%) of 6 patients who received steroid treatment combined with mycophenolate mofetil showed partial or complete clinical remission. No serious side effects and drug withdrawal were observed. Conclusion: OCP is a sight-threatening autoimmune disease that affects older adults. Although positive biopsy results are valuable for diagnosis, negative results do not exclude the diagnosis. The main treatment is systemic immunosuppressives. Disease activity can be suppressed, especially with early initiation of drug therapy. These patients require a multidisciplinary approach. Especially in the presence of isolated ocular findings, ophthalmologists should be able to make the decision to start immunosuppressive treatment, and systemic treatment should not be delayed. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the palliative efficacy of the intrastromal human amniotic membrane (hAM) surgery technique in patients with symptomatic bullous keratopathy and limited visual potential. Materials and Methods: The study was carried out retrospectively by reviewing the medical data of 10 patients with poor visual prognosis who underwent intrastromal hAM surgery due to bullous keratopathy-related severe pain. Visual acuity, surgical indication, epithelization time, preoperative and postoperative pain scores, as well as anterior segment optical coherence tomography images and anterior segment photographs were obtained from the medical records. Results: Ten patients (6 females/4 males) were included in the study. Nine patients underwent surgery for pseudophakic bullous keratopathy and glaucoma, and 1 patient due to graft failure and glaucoma. The mean time for corneal epithelization was 27.10±13.05 days (range, 10-50), while the mean follow-up time was 37.5±1.6 months (range, 36-39.2). Subjective pain score improved in all patients after surgery. Suture-induced keratitis occurred during follow-up in one patient and was controlled with medical treatment. Conclusion: Intrastromal amniotic membrane surgery may be an alternative to keratoplasty for pain palliation in patients with limited visual prognosis after corneal transplantation when donor tissue is scarce. With this method, hAM remains on the ocular surface longer, and superficial stromal excision is believed to provide a more regular ocular surface and extend the asymptomatic period. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate changes in the clinical findings of keratoplasty patients who could not be examined face-to-face and were followed up by telephone during the coronavirus disease 2019 (COVID-19) pandemic. Materials and Methods: Patients with penetrating keratoplasty who presented to the cornea department between March 2020 and February 2021 were grouped according to whether they showed clinical deterioration (Group 1: no deterioration, Group 2: deterioration). The patients' last visit prior to the COVID-19 pandemic and their first visit after the pandemic-related lockdown ended were evaluated. The demographic data, follow-up period, and ophthalmological examination findings of all patients were recorded and the data were compared between the groups. Results: Thirty-five eyes of 35 patients were included in the study. Signs of deterioration were detected in 8 (22.8%) of the patients (Group 1), while no deterioration was detected in 27 (77.2%) of the patients (Group 2). In the last follow-up visit prior to the COVID-19 pandemic, mean best corrected visual acuity (BCVA) was 1.26±0.43 LogMAR (range: 0.52-1.80) in Group 1 and 1.41±1.02 LogMAR (range: 0-3.1) in Group 2 (p=0.692). Mean BCVA in the first control during the pandemic was 2.07±0.86 LogMAR (range: 1.3-3.1) in Group 1 and 1.49±1.08 LogMAR (range: 0-3.1) in Group 2 (p=0.08). At the first visit during the COVID-19 pandemic, the mean intraocular pressure of Group 1 was 16.38±8.58 mmHg (range: 0-31), and Group 2 was 17.11±3.7 mmHg (range: 11-26) (p=0.984). Conclusion: The continuation of treatment initiated prior to the pandemic was probably the most important reason why deterioration was not observed in keratoplasty patients. In situations such as pandemics where face-to-face visits with patients may be disrupted, it may be possible to follow the patients safely with telemedicine visits until the difficult circumstances resolve. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate and compare the risk factors, presenting features, and outcomes of patients with culture-positive and culturenegative microbial keratitis (MK) who presented to a tertiary referral center. Materials and Methods: We conducted a retrospective review of the medical records of 314 patients who were diagnosed with MK in our clinic between 2012 and 2019. Results: Among 314 patients, 142 had positive cultures (45.2%). The mean ages of the culture-positive and -negative patients at the time of diagnosis were 51.39±21.31 (range, 14-90) years and 56.68±21.34 (7-94) years, respectively (p=0.028). The mean best corrected visual acuity (BCVA) of the culture-positive and -negative patients were1.74±1.25 (0-3.1) LogMAR and 1.91±1.23 (0-3.1) LogMAR prior to treatment and increased to 1.21±1.30 (0-3.1) LogMAR and 1.27± 1.29 (0-3.1) LogMAR at last visit, respectively. There was no statistically significant difference between culture-positive and -negative patients' BCVA levels at presentation or last visit. Ninetytwo patients (64.7%) were infected with bacteria and 50 patients (35.2%) with fungi. The most common pathogen was Pseudomonas aeruginosa (18.3%), followed by Streptococcus pneumoniae (11.2%) and Fusarium spp. (11.2%). Keratitis foci were either centrally or paracentrally located in 105 eyes (73.9%) of culture-positive patients and 149 eyes (86.6%) of culture-negative patients. Multiple foci were present mostly in culture-positive patients (p=0.001). There was no significant difference between the culture-positive and -negative groups in terms of hypopyon presence (p=0.364). The proportion of contact lens (CL) wearers was 33% (n=47) among culturepositive MK patients and 13.3% (n=23) among culture-negative MK patients, respectively (p<0.001). Culture positivity was found to be significantly higher in keratitis associated with CL use (p=0.0001). Conclusion: Microbiological analysis and culture evaluation are important steps in order to manage proper treatment in microbial keratitis. Prognosis mostly depends on the infectivity of the microbiological agent. [ABSTRACT FROM AUTHOR]

Objectives: To assess the anterior segment optical coherence tomography (AS-OCT) findings of various types of corneal foreign bodies. Materials and Methods: The medical records of patients with corneal foreign body were retrospectively analyzed. Patients who underwent anterior segment photography and Spectralis AS-OCT (Heidelberg Engineering GmbH, Germany) imaging were included. Results: The AS-OCT findings of 22 eyes of 20 patients with corneal foreign body were reviewed. The mean age was 34.9±14.98 years (range, 15-71) with a female/male ratio of 4/16. The mean best corrected visual acuity at presentation was 0±0 LogMAR (range, 0-0). There were 18 metallic, 3 organic (chestnut burr), and 1 chemical clay foreign bodies. The metal materials demonstrated hyperreflectivity with a mirror effect. Chemical clay, which is an opaque material, had a hyperreflective appearance. Chestnut burr is an organic foreign body with a feather-like pattern and was not detected with AS-OCT. Conclusion: AS-OCT is a valuable non-invasive tool to define the characteristics of foreign bodies, as well as decide the proper treatment method and monitor patients with corneal foreign bodies. [ABSTRACT FROM AUTHOR]

To investigate the corneal biomechanical properties of keratoconic eyes following penetrating keratoplasty (PKP). Materials and Methods: Thirty-five patients (70 eyes) were enrolled to this prospective study. Operated and contralateral keratoconic eyes were defined as Group 1 and 2, respectively. All patients underwent ophthalmological examination and measurements of corneal biomechanical properties by Ocular Response Analyzer (ORA), intraocular pressure (IOP) by Goldmann applanation tonometry, and central corneal thickness (CCT) by Pentacam. Shapiro-Wilk W test was performed to test normality of the data. The statistical significance was evaluated with the paired t-test and Wilcoxon signed ranks test. Pearson correlation and Spearman rho tests were used for correlation analysis. Results: The average age and male/female ratio were 31.34±11.65 (15-60) years and 21/14, respectively. The mean values of the data obtained from Group 1 and 2 respectively were: corneal hysteresis (CH): 9.35±1.66, 8.18±1.84 mmHg (p=0.013), corneal resistance factor (CRF): 9.48±1.96, 7.14±2.05 mmHg (p<0.001), IOPcc: 16.90±4.32, 14.26±3.69 mmHg (p=0.004), IOPg: 15.45±4.61, 10.91±3.97 mmHg (p<0.001), IOPapl: 14.26±3.11, 13.09±2.54 mmHg (p=0.046), and central corneal thickness (CCT): 545.64±60.82, 442.60±68.14 μM (p<0.001). The positive correlation between CH and CRF was moderate (r=0.444) in Group 1 and strong (r=0.770) in Group 2. There was a moderate negative correlation between CH and IOPcc in both groups (r=-0.426, r=-0.423), but CH was not correlated with IOPg or IOPapl in either group. There were weak to strong positive correlations between CRF and all IOP values in both groups. There was no correlation between CRF and CCT in Group 1 (r=0.075) and a very weak correlation in Group 2 (r=0.237). Only IOPcc and IOPg were strongly correlated in both groups. Conclusion: Better understanding of corneal biomechanical properties is essential for elucidating the pathophysiology and diagnosis of several corneal pathologies such as keratoconus. The biomechanical properties of keratoconic eyes seem to be closer to normal values after PKP. [ABSTRACT FROM AUTHOR]

The cornea is the outermost tissue of the eye and it must be transparent for the maintenance of good visual function. The superficial epithelium of the cornea, which is renewed continuously by corneal stem cells, plays a critical role in the permanence of this transparency. These stem cells are localized at the cornea-conjunctival transition zone, referred to as the limbus. When this zone is affected/destroyed, limbal stem cell deficiency ensues. Loss of limbal stem cell function allows colonization of the corneal surface by conjunctival epithelium. Over 6 million people worldwide are affected by corneal blindness, and limbal stem cell deficiency is one of the main causes. Fortunately, it is becoming possible to recover vision by autologous transplantation of limbal cells obtained from the contralateral eye in unilateral cases. Due to the potential risks to the donor eye, only a small amount of tissue can be obtained, in which only 1-2% of the limbal epithelial cells are actually limbal stem cells. Vigorous attempts are being made to expand limbal stem cells in culture to preserve or even enrich the stem cell population. Ex vivo expanded limbal stem cell treatment in limbal stem cell deficiency was first reported in 1997. In the 20 years since, various protocols have been developed for the cultivation of limbal epithelial cells. It is still not clear which method promotes effective stem cell viability and this remains a subject of ongoing research. The most preferred technique for limbal cell culture is the explant culture model. In this approach, a small donor eye limbal biopsy is placed as an explant onto a biocompatible substrate (preferably human amniotic membrane) for expansion. The outgrowth (cultivated limbal epithelial cells) is then surgically transferred to the recipient eye. Due to changing regulations concerning cell-based therapy, the implementation of cultivated limbal epithelial transplantation in accordance with Good Laboratory Practice using xenobiotic-free systems is becoming widely accepted both in Turkey and worldwide. [ABSTRACT FROM AUTHOR]

A 10-year-old girl was brought to the clinic with the complaint of a salmon-colored conjunctival lesion for 1 month. With the aid of histopathological evaluation and other tests, extranodal ocular adnexal marginal zone lymphoma was diagnosed. The patient was graded as T1bN0M0 according to AJCC and Stage 1 according to Ann Arbor classification. She was treated with external radiotherapy at 1.8 Gy/day for 17 days for a total dose of 36 Gy. She is in remission for 26 months and still being followed up. [ABSTRACT FROM AUTHOR]

BACKGROUND: The aim of this study was to evaluate risks and consequences of traumatic wound dehiscence after penetrating keratoplasty (PK), METHODS: Data regarding 34 eyes of 34 patients who were treated for traumatic wound dehiscence after PK between 1995 and 2014 were studied. Patient records were reviewed for type and time of insult, corrected distance visual acuity (CDVA), clinical presentation signs, operative method, and outcome. RESULTS: The interval between PK and trauma ranged from I month to 100 months, with median of 14 months. Median age at trauma was 31.5 years (range: 5-81 years). Wound dehiscence occurred at donor-recipient interface in all patients. In 58.8% of patients, extent of dehiscence was >6 clock hours. Most frequent type of trauma was blunt trauma by hand/finger (35.2%). Median CDVA before and just after trauma were 0.5 logMAR (range: 0.1-3.0 logMAR) and 3.0 logMAR (range: 0.7-3.0 logMAR), respectively. Wound dehiscence was managed with primary wound closure in all patients. Most frequent additional surgical procedure was anterior vitrectomy (26.4%). Anatomical globe loss occurred in 2 patients. Median CDVA was 0.7 logMAR (range: 0.1-3.0 logMAR) at final visit. Most common complication after primary suturation was graft failure (23.5%). Graft remained clear in 67.6% of patients. CONCLUSION: Traumatic wound dehiscence is one of the potentially devastating postoperative complications that can occur following PK. Prognosis depends on existence and severity of additional anterior/posterior segment damage. In order to prevent this catastrophic condition, patients should be warned against ocular trauma after undergoing PK. [ABSTRACT FROM AUTHOR]

To report the diagnosis and effective treatment of corneal edema due to Descemet's membrane detachment following uneventfully completed phacoemulsification surgery in a case. A 72-year-old female patient was referred to our clinic with a continuing gradual deterioration of vision and diffuse corneal edema in her right eye, 12 days after an uneventful phacoemulsification surgery. Her visual acuity was counting fingers from 2 meters in the right eye and 0.4 in the left eye. Slit lamp examination revealed a corneal edema mostly prominent at the central and medial cornea with a Descemet's membrane detachment near the medial site port area in the right eye. There was a mild nuclear cataract in the left eye. Intraocular pressures were normal in both eyes. The patient had a medical history of arterial hypertension. Descemet's membrane detachment which was close to the medial side port area was detected on a detailed slit lamp examination, and anterior chamber tamponade was performed with perfluoropropane (C3F8) under topical anesthesia. At the third postoperative day, her right eye was comfortable, the corneal epithelial edema had almost cleared, and the Descemet's membrane appeared to be reattached completely with only small wrinkles remaining. Her visual acuity improved to 0.5 in the right eye. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 1-year follow-up results of cultivated limbal epithelial cell (CLEC) transplantation in unilateral limbal stem cell deficiency (LSCD). Material and Method: One-year follow-up results of five unilateral LSCD patients who had undergone CLEC transplantation were evaluated. Parameters for this evaluation were: fluorescein staining of ocular surface, corneal vascularization and status of epithelium with slit lamp, and visual acuity. 1.5-mm limbal biopsy was performed from the superior limbus of the healthy eyes, broke into two equal pieces, expanded on human amniotic membrane (hAM) and inserts for 14 days until getting 20 mm in size. CLECs on hAMs were used directly, and cells on inserts were used after detachment procedure. The symblepharon and pannus tissues were removed, superficial keratectomy was performed. CLEC on hAMs were transplanted with the epithelial side up onto the bare corneal stroma, sutured to the conjunctiva with 10-0 nylon sutures. Free CLEC layer from insert was placed on hAM as a second layer, additional hAM was used as a protective layer all over other tissues. Results: Median age was 44.4 years (14-71). The etiology was chemical burn in all patients. Median duration of symptoms was 10 years (2-18), median follow-up period was 12.6 (12-12.5) months. Preoperative best corrected visual acuities (BCVA) were light perception in three patients, counting fingers at 50 cm in one patient and 3/10 in one patient. Visions were improved in all patients. Postoperative BCVA 12 months after the surgery were between counting fingers at 3 meters to 6/10. There was a temporary hemorrhage between the two layers of hAMs in one patient at the early postoperative period. Peripheral corneal vascularization has occurred in three patients, in patient corneal vascularization has reached to the paracentral area. Discussion: CLEC transplantation is an efficient treatment option for unilateral LSCD in mid-long term. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy and safety of intravitreal ranibizumab monotherapy for choroidal neovascularization (CNV) secondary to age-related macular degeneration patients. Material-Method: This was a non-randomized, observational, retrospective trial during the period from April 2008 to January 2010 with data collection of 73 eyes from 65 consecutive CNV patients who underwent ranibizumab injection. Data collection at all visits included best-corrected visual acuity (BCVA), detailed ophthalmological examination, OCT measurements, FA and retinal photography. All patients were treated with intravitreal ranibizumab, three times monthly. Additional ranibizumab was performed if one of the following changes was observed; the spreading of lesion, increased central macular thickness (>300 µm), signs of active CNV leakage on FA, new hemorrhage and loss of BCVA ?5 letters on the ETDRS chart. Patients were followed up monthly. Results: Mean age was 71.3±9.4 years (40-90). 33 of patients were female and 32 of patients were male. Mean follow up period was 6.8±4.9 (4-20) months. 21 patients (28.8%) were pseudophakic. Occult CNV was present in 45 eyes (61.4%), classic CNV was present in 23 (31.8%) eyes and fibrovascular PED was present in 5 (6.8%) eyes. Mean BCVA was 0.8±0.5 logMAR before the injection and 0.6±0.4 logMAR at last visit. Mean BCVA significantly improved (p=0.001) in all eyes but there was no statistically difference between subgroups (p>0.05). There was no major complication related to injections. Conclusion: Intravitreal ranibizumab monotherapy was effective in significantly increasing and stabilizing BCVA in CNV secondary to age-related macular degeneration patients. After ranibizumab treatment regression of neovascularization was observed and no side effects were recorded. [ABSTRACT FROM AUTHOR]

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Purpose: To evaluate the retinal nerve fiber layer thickness (RNFLT) in optic disc swelling by using Heidelberg Retina Tomography (HRT) and Optical Coherence Tomography(OCT). Materials and Methods: 40 patients with swollen optic disc and 41 healthy subjects were enrolled in the study. Ophthalmological examination, Mean RNFLT measurements with HRT III and OCT were performed. Results: There were 17 women and 23 men. The mean age was 41.3±17.3 years in the patient group and 47.8±10.1 years in the control group. The involved eye in unilateral cases and more seriously affected eye in bilateral cases were taken into consideration. There were 11 pseudotumor cerebri (PTC), 11 nonarteritic anterior ischemic optic neuropathy (NAION), 8 optic disc drusen (ODD), 6 central retinal vein occlussion (CRVO) and 4 optic neuritis (ON). The mean RNFLT was 176.10 μm, 251.47 μm in patient group and 98.85 μm, 275.60 μm in control group with OCT and HRT. There was a statistically significant positive correlation between two methods in patient group. However, there was no correlation in control group. RNFLT was found significantly higher in control group than in NAION subgroup with HRT. RNFLT was found significantly higher in all groups than in control group and significantly higher in PTC group than ODD group with OCT. Conclusion: Although, a positive correlation of RNFLT between HRT and OCT was found in patient group; much thicker measurements were obtained by using HRT. The results of our study showed that OCT for detecting RNFLT may be more useful in the differential diagnosis of optic disc swelling. [ABSTRACT FROM AUTHOR]

Medical records of two patients treated for radiation retinopathy in our clinic were evaluated retrospectively to assess the efficacy of various intravitreal injections. Age of the patients was 28 and 53. The time interval between radiotherapy and radiation retinopathy was 3 years in the first patient and one year in the second. First patient received no prior treatment. Second patient had a history of left vitrectomy for a presumed diagnosis of retinal vein occlusion at another institute. First patient's visual acuity was 2/10 in the right eye and 4/10 in the left eye while second petient's visual acuity was counting fingers at 2 meters in the right eye and counting fingers at 4 meters in the left eye. Their posterior segment examinations revealed changes compatible with radiation retinopathy. There was no retinal or disc neovascularization. Second patient had also signs of optic neuropathy in the left eye. Both patients had multiple intravitreal injections of triamcinolone acetonide, bevacizumab and pegaptanib sodium. Early after injections visual acuity and clinic manifestations became slightly better but re-injections deemed necessary due to recurrent macular oedema. There is no consensus on treatment of radiation retinopathy but intravitreal injections may limit the damage and have a role in the treatment of macular oedema due to radiation retinopathy. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 1-year follow-up results of cultivated limbal epithelial cell (CLEC) transplantation in unilateral limbal stem cell deficiency (LSCD)., Material and Method: One-year follow-up results of five unilateral LSCD patients who had undergone CLEC transplantation were evaluated. Parameters for this evaluation were: fluorescein staining of ocular surface, corneal vascularization and status of epithelium with slit lamp, and visual acuity. 1.5-mm limbal biopsy was performed from the superior limbus of the healthy eyes, broke into two equal pieces, expanded on human amniotic membrane (hAM) and inserts for 14 days until getting 20 mm in size. CLECs on hAMs were used directly, and cells on inserts were used after detachment procedure. The symblepharon and pannus tissues were removed, superficial keratectomy was performed. CLEC on hAMs were transplanted with the epithelial side up onto the bare corneal stroma, sutured to the conjunctiva with 10-0 nylon sutures. Free CLEC layer from insert was placed on hAM as a second layer, additional hAM was used as a protective layer all over other tissues., Results: Median age was 44.4 years (14-71). The etiology was chemical burn in all patients. Median duration of symptoms was 10 years (2-18), median follow-up period was 12.6 (12-12.5) months. Preoperative best corrected visual acuities (BCVA) were light perception in three patients, counting fingers at 50 cm in one patient and 3/10 in one patient. Visions were improved in all patients. Postoperative BCVA 12 months after the surgery were between counting fingers at 3 meters to 6/10. There was a temporary hemorrhage between the two layers of hAMs in one patient at the early postoperative period. Peripheral corneal vascularization has occurred in three patients, in patient corneal vascularization has reached to the paracentral area., Discussion: CLEC transplantation is an efficient treatment option for unilateral LSCD in mid-long term.