Purpose: To report a case series of seven eyes (six patients) with severe limbal stem cell failure who underwent cultivated oral mucosa epithelium transplantation (COMET) in preparation for corneal transplant surgery and assess the change in visual acuity postoperatively.

Design: Case series.

Methods: A retrospective analysis of an interventional case series of six patients with severe limbal stem cell deficiency who underwent COMET between 2012 and 2015 was performed. Six eyes had COMET followed by corneal transplant, and one eye had corneal transplant preceding COMET. The change in the visual acuity after operation was evaluated.

Results: A total of six patients with seven eyes were studied. All of them had severe ocular surface disease with limbal stem cell deficiency (LSCD) secondary to chemical injury (five eyes), SJS (one eye), and severe ocular rosacea (one eye). Four eyes had improvements in visual acuity, two of which achieved best corrected visual acuity (BCVA) of 6/12.

Conclusion: The use of COMET helps to optimize the ocular surface in severe LSCD for further corneal transplant surgeries. It has helped to improve the graft uptake and subsequent visual improvement, especially in chronic chemical burn cases.