Purpose: To assess the anatomic and visual results of the modified glueless simple limbal epithelial transplantation (G-SLET) in the treatment of unilateral limbal stem cell deficiency (LSCD). Methods: This is a retrospective analysis of 2 patients who received G-SLET for corneal reepithelization after unilateral eye burn. After the recipient bed preparation on the eye with LSCD, radial symmetrical superficial incisions were applied to the corneal periphery. Next, short (1 mm) slightly oblique or horizontal tunnels were formed in every incision. The precut limbal pieces from the healthy eye were inserted into the tunnels with a scleral portion forward. At the end of surgery, the amniotic membrane was sutured to the sclera outside the corneal limbus with a single running suture. Results: Slit lamp examination in the early postoperative period revealed that transplanted limbal pieces remained in place and were visible through the semitransparent amniotic membrane. The donor's eye had a small scar and light subconjunctival hemorrhage. Early and late postoperative periods were uneventful. Twelve months after surgery, the LSCD-affected cornea was entirely covered with tight and semitransparent epithelium. The donor's eye exhibited a small scar on the site of the biopsy. Visual improvement was achieved in case 2, but the vision did not improve due to the presence of a mature cataract in case 1. Conclusions: Modified G-SLET technique could be an option for LSCD treatment in patients with unilateral eye disease in cases when fibrin glue is not available for the surgeon.

A two-photon laser femtosecond crosslinking process at the wavelength of 525 nm was studied in a human donor cornea in the presence of riboflavin using two-photon optical microscopy and nanoindentation. It was shown that such an approach results in efficient crosslinking of the corneal collagen and a significant (three-fold) increase in the Young's modulus of the corneal structure. Application of a femtosecond laser with the wavelength of 525 nm allows a drastic enhancement of efficiency in the presence of riboflavin on human corneas and a 50-fold reduction of the laser treatment duration in comparison with the use of a femtosecond laser with the wavelength of 760 nm. We relate this effect to a significant growth in the coefficient of two-photon absorption due to the laser wavelength falling within the edge of the photoinitiator (riboflavin) absorption band. Our studies on a donor human cornea demonstrate the good potential for the clinical application of a femtosecond laser with the wavelength of 525 nm for increasing the cornea rigidity using the two-photon laser femtosecond crosslinking technique.

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