[Limbal epithelial stem cell transplantation : Current state and perspectives]
1Klinik für Augenheilkunde, Universitätsklinikum Jena, Bachstr. 18, 07743, Jena, Deutschland. Daniel.Meller@med.uni-jena.de.
Summary
Limbal stem cell deficiency (LSCD) impairs corneal healing, leading to conjunctival invasion. Treatments range from amniotic membranes for partial LSCD to stem cell transplantation for complete LSCD, with ongoing research into alternative cell sources.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Stem Cell Biology
Background:
- Corneal homeostasis relies on limbal epithelial stem cells.
- Injury or intrinsic factors can cause limbal stem cell deficiency (LSCD), impeding corneal re-epithelialization.
- LSCD leads to conjunctival invasion of the corneal surface.
Purpose of the Study:
- To review current and emerging strategies for managing limbal stem cell deficiency.
- To discuss surgical and cultivation techniques for stem cell transplantation.
- To explore alternative tissue sources for corneal reconstruction.
Main Methods:
- Review of existing literature on LSCD management.
- Description of surgical procedures for partial and complete LSCD.
- Discussion of stem cell harvesting, cultivation, and transplantation techniques.
Main Results:
- Partial LSCD can be managed with superficial keratectomy and amniotic membrane grafts.
- Complete LSCD necessitates stem cell transplantation, with options including autologous (contralateral eye) or allogeneic grafts.
- Autologous non-corneal epithelial cells, such as buccal mucosa, represent a newer therapeutic avenue.
Conclusions:
- Effective management of LSCD requires addressing underlying causes and optimizing comorbidities.
- Stem cell transplantation is crucial for complete LSCD, with advancements in tissue-saving harvesting and cultivation.
- Future research aims to enhance cellular expansion and identify novel sources for limbal epithelial stem cell replacement.
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