Burman and Sangwan Figure 7 A. Slit lamp photograph of a patient with total limbal stem cell deﬁciency with extensive symblephara following alkali 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. human corneal epithelial medium for ex vivo cultivation. The 3T3 ﬁbroblast feeder layer or air lifting as described by other researchers is not used. Lastly, a conﬂuent monolayer is transplanted rather than awaiting in vitro stratiﬁcation. Conclusion The transplantation of cultivated limbal stem cells is a promising new alternative for ocular surface reconstruc- tion in patients with LSCD. The procedure signiﬁcantly minimizes the risk of iatrogenic LSCD in the donor eye. The results of autologous cultivated limbal stem cell trans- plants are particularly encouraging and allows for banking of the patient’s cells for repeat procedures. Although much progress has been achieved with constant modiﬁcations to the technique of cultivation and transplantation, there is much to be learnt before a successful bioengineered corneal tissue replacement is conceived for this challenging group of patients. 500 Clinical Ophthalmology 2008:2(3)