Cultivated limbal stem cell transplantation corneal surfaces were clear, although three eyes experi- enced epithelial rejection. Sangwan and colleagues (2006) have reported the clini- cal outcome of autologous CLSCT in the largest series of patients with LSCD. The success of the procedure was de- ﬁned by a stable ocular surface and subjective improvement in the symptoms of the patient with a minimum follow up of 6 weeks (Figure 6). The stability of the ocular surface was assessed clinically, based on absence of recurrent breakdown of the corenal epithelium, increased permeability to ﬂuorescein, or conjunctivalization. Eighty-eight eyes of 86 patients with LSCD underwent autologous cultivated limbal epithelium transplantation, with a mean follow-up of 18.3 months. The etiology of LSCD was alkali burns in 64% patients. Sixty-one eyes had total LSCD (Figures 7A, 7B). Thirty-two of the 88 eyes had undergone amniotic membrane transplantation and 10 eyes had previously undergone lim- bal transplantation with unfavorable outcome. Nineteen eyes underwent penetrating keratoplasty, of which 11 grafts survived at the ﬁnal follow-up (Figures 8A, 8B, 8C, 8D). Finally, 57 eyes (73.1%, 95% CI: 63.3–82.9) had a successful outcome with a stable ocular surface without conjunctivalization, 21 eyes (26.9%, 95% CI: 17.1–36.7) were considered failures and 10 patients were lost to follow- up. They propose a novel technique of submerged explant culture wherein denuded HAM is used as a substrate and Figure 6 Slit lamp photograph of a patient with total limbal stem cell deﬁciency (A) with multiple symblephara following acid injury. (B) One year after autologus culti- vated limbal stem cell transplantation shows clear central cornea and no recurrence of symblephara and a stable ocular surface. Clinical Ophthalmology 2008:2(3) 499