This study compared the long-term outcome of different epithelial transplantation techniques to treat limbal stem cell deficiency (LSCD). We conducted a retrospective 15-year comparative systematic cohort study of patients with LSCD who underwent either cultivated limbal epithelial transplantation (CLET), simple limbal epithelial transplantation (SLET), or cultivated oral mucosal epithelial transplantation (COMET). We reviewed the demographic data, etiology, LSCD severity, best-corrected visual acuity, surgical outcomes, and complications. A total of 103 eyes of 94 patients (mean age, 45.0 ± 16.4 years) with LSCD were enrolled. The most common cause of LSCD was chemical injury (42.7 %). The median follow-up time was 75 months. The success rates of CLET, SLET, and COMET were 45.5 %, 77.8 %, and 57.8 %, respectively. The 7-year survival rates after CLET, SLET, and COMET were 50.0 %, 72.2 %, and 53.2 %, respectively. Steven-Johnson syndrome (SJS) had a significantly lower survival rate than other causes (p < 0.001), but SLET had a significantly higher survival rate than CLET (p = 0.018) and COMET (p = 0.047). Visual improvement of more than four Snellen lines was achieved in 53.1 % of successful cases and 28.2 % of failed cases. SJS, Schirmer I test <5 mm, and the presence of postoperative recurrent epithelial defects were significant risk factors for a failed surgery. All epithelial transplantation techniques had favorable long-term surgical outcomes. More than half of the patients achieved a stable ocular surface and visual acuity improvement up to 7 years postoperatively. SLET tends to have a better surgical outcome than CLET and COMET, especially in patients with SJS.

中文翻译：

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三种上皮细胞移植治疗角膜缘干细胞缺乏症的长期效果比较分析

这项研究比较了不同上皮移植技术治疗角膜缘干细胞缺乏症（LSCD）的长期结果。我们对接受培养性角膜缘上皮移植 (CLET)、单纯性角膜缘上皮移植 (SLET) 或培养性口腔粘膜上皮移植 (COMET) 的 LSCD 患者进行了一项回顾性 15 年比较系统队列研究。我们回顾了人口统计数据、病因、LSCD 严重程度、最佳矫正视力、手术结果和并发症。共纳入 94 名 LSCD 患者（平均年龄 45.0 ± 16.4 岁）的 103 只眼睛。LSCD 最常见的原因是化学损伤（42.7%）。中位随访时间为 75 个月。CLET、SLET 和 COMET 的成功率分别为 45.5%、77.8% 和 57.8%。CLET、SLET 和 COMET 后的 7 年生存率分别为 50.0%、72.2% 和 53.2%。Steven-Johnson 综合征 (SJS) 的生存率显着低于其他原因 (p < 0.001)，但 SLET 的生存率显着高于 CLET (p = 0.018) 和 COMET (p = 0.047)。53.1% 的成功病例和 28.2% 的失败病例实现了超过 4 条 Snellen 线的视力改善。SJS、Schirmer I 测试 <5 mm 以及术后复发性上皮缺损是手术失败的重要危险因素。所有上皮移植技术均具有良好的长期手术结果。超过一半的患者术后7年实现了稳定的眼表和视力改善。SLET 往往比 CLET 和 COMET 具有更好的手术效果，特别是对于 SJS 患者。