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  Indian J Med Microbiol
 

Figure 2: Utility of anterior-segment optical coherence tomography (AS-OCT) before simple limbal epithelial transplantation (SLET). The top row shows four different cases of total limbal stem cell deficiency (LSCD), where clinically the fibrovascular pannus is too thick to estimate underlying corneal stromal clarity or thickness (a to d). The middle row shows the infrared photographs of the same eyes captured by the AS-OCT, revealing increasing grades of underlying stromal opacification (from left to right) obscuring the discernibility of the pupil (e to h). The bottom row shows the linear scans of the AS-OCT imaging, revealing the huge variation in the underlying corneal stromal thickness (i to l). The vertical white bar in the bottom row indicates 250 microns of corneal thickness. The second case, summarized in the images of the second column (b, f, and j) is ideal for SLET. The first case (a, e, and i) would require very careful dissection and there is a serious risk of intraoperative corneal perforation; it may be preferable to do an anterior lamellar keratoplasty with SLET. The third (c, g, and k) and fourth cases (d, h, and i) show significant underlying corneal damage and SLET alone is not recommended as it will not improve corneal clarity (vision) or appearance of the eye (cosmesis)

Figure 2: Utility of anterior-segment optical coherence tomography (AS-OCT) before simple limbal epithelial transplantation (SLET). The top row shows four different cases of total limbal stem cell deficiency (LSCD), where clinically the fibrovascular pannus is too thick to estimate underlying corneal stromal clarity or thickness (a to d). The middle row shows the infrared photographs of the same eyes captured by the AS-OCT, revealing increasing grades of underlying stromal opacification (from left to right) obscuring the discernibility of the pupil (e to h). The bottom row shows the linear scans of the AS-OCT imaging, revealing the huge variation in the underlying corneal stromal thickness (i to l). The vertical white bar in the bottom row indicates 250 microns of corneal thickness. The second case, summarized in the images of the second column (b, f, and j) is ideal for SLET. The  first case (a, e, and i) would require very careful dissection and there is a serious risk of intraoperative corneal perforation; it may be preferable to do an anterior lamellar keratoplasty with SLET. The third (c, g, and k) and fourth cases (d, h, and i) show significant underlying corneal damage and SLET alone is not recommended as it will not improve corneal clarity (vision) or appearance of the eye (cosmesis)