From: Novel Molecular Diagnostic System of Limbal Stem Cell Deficiency Based on MUC5AC Transcript Detection in Corneal Epithelium by PCR-Reverse Dot Blot Invest. Ophthalmol. Vis. Sci.. 2013;54(8):5643-5652. doi:10.1167/iovs.13-11933 Figure Legend: Decision tree for LSCD management. The molecular diagnostic test reported here is recommended in cases in which any sign(s) or signal(s) of LSCD is apparent, when monitoring risk groups such as long-term soft lens users, or in situations in which surgical or treatment decisions require verification of the pathological condition. A negative result from the molecular test suggests that a regular PK or DALK procedure may be appropriate. In the presence of a positive result and confirmation of LSCD in the affected eye, the contralateral eye should be evaluated. A negative result of the molecular test in the fellow eye confirms that it can be a donor for autologous limbal transplant or ex vivo expansion of limbal stem cells. When a positive result is obtained in the fellow eye, other surgical alternatives, such as allogenic limbal transplant, keratoprosthesis, or ex vivo expansion of autologous oral mucosal epithelial cells, ethmoidal mucosa or mesenchymal stem cells should be indicated. Date of download: 10/27/2017 The Association for Research in Vision and Ophthalmology Copyright © 2017. All rights reserved.