title: Primary Simple Limbal Epithelial Transplantation Along With Excisional Biopsy in the Management of Extensive Ocular Surface Squamous Neoplasia.
abstract: OBJECTIVE
  To describe the utility of simple limbal epithelial transplantation (SLET) along with tumor excision in the management of extensive ocular surface squamous neoplasia (OSSN) to avoid limbal stem cell deficiency (LSCD).
  
  
  METHODS
  This case report describes the management of a 75-year-old man clinically diagnosed with OSSN involving more than 3 quadrants of limbus. The excisional biopsy of tumor along with 4-mm healthy margin led to a complete loss of the limbus, which was restored by limbal epithelial cell transplantation using the SLET technique in the same setting.
  
  
  RESULTS
  The tumor was found adherent to the episclera in the superotemporal quadrant and required episcleral and superficial lamellar scleral dissection. The entire tumor could be excised, and complete reepithelialization of the cornea was seen within 2 weeks. Histopathology showed tumor cells infiltrating the stroma and base of the excision biopsy, suggesting invasive squamous cell carcinoma. The excised margins were tumor free. To prevent recurrence, the patient underwent radiotherapy (plaque brachytherapy). After a follow-up period of 2 years, a successful outcome in the form of a stable ocular surface, no tumor recurrence, and no signs of LSCD was achieved in our patient.
  
  
  CONCLUSIONS
  Restoration of limbal stem cells using SLET technique in an extensive OSSN in the primary setting may be pertinent to a good outcome.
authors.affiliation: *Cornea and Anterior Segment Services, Sanjivni Eye Care Ambala, Haryana, India;†Oculoplasty and Ocular Oncology Services, Centre for Sight, New Delhi, India;‡Vitreoretina and Uveitis Services, Sanjivni Eye Care Ambala, Haryana, India; and§Oculoplasty and Ocular Oncology Services, Centre for Sight, Hyderabad, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Mittal
authors.forename: Purvasha
authors.initials: P
authors.lastname: Narang
authors.forename: Vikas
authors.initials: V
authors.lastname: Menon
authors.forename: Ruchi
authors.initials: R
authors.lastname: Mittal
authors.forename: Santosh
authors.initials: S
authors.lastname: Honavar
mesh_terms: D000368:Aged; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D003316:Corneal Diseases / Q000601:surgery*; D019573:Epithelium, Corneal / Q000637:transplantation*; D005134:Eye Neoplasms / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D013508:Ophthalmologic Surgical Procedures / Q000379:methods; D062326:Re-Epithelialization; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D014792:Visual Acuity