The corneal epithelial surface is maintained in a transparent state by the corneal epithelial stem cells, which are believed to be located at the basal layer of the limbal epithelium.^1,2 Any physical, chemical, thermal, or immunologic insult to the limbal region can result in permanent damage to the corneal epithelial stem cells, leading to limbal stem cell deficiency (LSCD). This deficiency results in loss of corneal clarity and a decrease in vision, often leading to unilateral and bilateral corneal blindness.³ With the advent of different techniques of limbal stem cell transplantation, it has become possible to treat eyes with blindness due to LSCD.^4-6 There are several articles^7-13 about the use of conventional and cultured limbal epithelium using various substrates in the treatment of LSCD. However, the patient population includes largely adults, with few pediatric cases. Thus, to our knowledge, the outcomes of this procedure exclusively in a pediatric population have not been reported previously. It is known that the ocular inflammatory responses to iatrogenic trauma can be more severe in pediatric patients compared with adults, which, in turn, can jeopardize the final outcome of the surgical procedure. In this study, we describe the clinical outcomes of autologous ex vivo cultivated limbal epithelial transplantation (CLET) in children with unilateral LSCD after ocular surface burns, using a standardized xeno-free protocol of limbal cell culture.

Purpose To report the surgical outcomes of Descemet's stripping endothelial keratoplasty (DSEK) in cases of congenital hereditary endothelial dystrophy (CHED) cohort and compare it with penetrating keratoplasty (PK) in a paired-eye setting. Methods Ours is a retrospective, comparative, consecutive and interventional clinical case series. All patients less than 14 years of age who underwent PK in one eye and DSEK in the contralateral eye at a single centre from January 2006 and February 2011 were analysed. Main outcome measures were graft clarity, visual outcome and complications. Results The mean age of the patients was 6.6±2.19 years at the time of presentation. The outcomes of two surgeries were compared with 1 year of follow-up at the corresponding follow time. At 1 year, all grafts were clear. There was no significant difference in the spherical component of the refraction; the astigmatism was significantly lower after EK. The refraction stabilised in patients with EK as early as 3 months, while it continued to change up to 1 year after PK. Complications included graft dislocation in two cases of DSEK, which were managed by rebubbling, and a graft dehiscence in one case of PK, which was managed by resuturing. The final visual acuity improved in all the patients. Conclusions Endothelial keratoplasty is a viable option to conventional PK in cases of CHED. It offers an advantage of early visual stabilisation compared with PK.

Optical coherence tomography (OCT) is analogous to ultrasound biometry in the cross sectional imaging of ocular tissues. Development of current devices with deeper penetration and higher resolution has made it popular tool in clinics for visualization of anterior segment structures. In this review, the authors discussed the application of AS-OCT for diagnosis and management of various corneal and ocular surface disorders. Further, recent developments in the application of the device for pediatric corneal disorders and extending the application of OCT angiography for anterior segment are introduced.