Eight-Year Outcomes of Staged Penetrating Keratoplasty After Simple Limbal Epithelial Transplantation in Ocular Surface Burns: A Case Report.

PURPOSE: The purpose of this article was to report long-term outcomes of staged simple limbal epithelial transplantation (SLET) followed by penetrating keratoplasty (PKP) in patients with severe ocular surface burns. METHODS: Two patients with unilateral severe ocular surface burns and limbal stem cell deficiency (LSCD) underwent SLET performed by a single surgeon. After ocular surface stabilization, sequential PKP combined with cataract extraction and posterior chamber intraocular lens implantation was performed. Patients were followed for 8 years. Anatomical success (stable, epithelized surface, and clear graft) and functional outcomes (best-corrected visual acuity) were assessed. RESULTS: Both eyes achieved sustained ocular surface stability before keratoplasty. At 8 years, clear grafts with stable epithelium were maintained in both cases. Final best-corrected visual acuity was 20/20 (with contact lens) and 20/120, respectively. No episodes of graft rejection, persistent epithelial defects, or vision-threatening complications were observed during follow-up. CONCLUSIONS: A staged approach with SLET followed by PKP may provide favorable long-term anatomical and visual outcomes in selected patients with severe ocular surface burns and LSCD. Larger studies are needed to validate these findings.