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948, p0.01). The maximum sensitivity (100%) and specificity (72.7%) were reached at a cut-off of 1.785 µL/min/cm . Patients with preoperative MSGFR 1.785 µL/min/cm showed greater improvement of Schirmer test values after surgery than those with MSGFR ≤1.785 µL/min/cm (p0.05). MSGs transplantation proved to be useful for treating severe DED. The amount of postoperative lubrication and the treatment effect were positively correlated with preoperative MSGFR. MSGFR measurement and donor-site selection should be critical steps