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Advancing Bilateral Limbal Deficiency Surgery: A Comprehensive Review of Innovations with Mucosal Cells
Zahra Bibak-Bejandi1, Mohammad Soleimani1, Zohreh Arabpour1
1Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL 60612, USA.
Biomedicines
|March 28, 2025
Summary
Simple oral mucosal transplantation (SOMT) offers an easier, faster, and more affordable method for limbal regeneration compared to other techniques. This approach effectively addresses bilateral limbal deficiency by utilizing mucosal cells when other sources are unavailable.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Tissue Engineering
Background:
- Bilateral limbal deficiency presents challenges, necessitating alternative limbal cell sources beyond traditional grafts like KLAL and LR-CLAL.
- Mucosal cells are a viable alternative source for limbal tissue restoration, particularly when fellow eye cells are inaccessible.
Purpose of the Study:
- To review advancements in surgical techniques for limbal regeneration using mucosal cell transplantation.
- To compare the efficacy and practicality of different mucosal cell transplantation methods.
Main Methods:
- Review of current surgical techniques for limbal regeneration, including cultivated oral mucosal transplantation (COMT), oral mucosal graft transplantation (OMGT), and simple oral mucosal transplantation (SOMT).
- Analysis of the advantages and disadvantages of each method, focusing on accessibility, time, cost, and outcomes.
Main Results:
- Simple oral mucosal transplantation (SOMT) emerges as a more efficient, time-saving, and affordable option compared to COMT and OMGT.
- Mucosal cell transplantation can stabilize the ocular surface, though challenges like angiogenesis and achieving full limbal stem cell differentiation persist.
- Co-culturing limbal niches within mucosal cell cultures may enhance differentiation potential, highlighting the importance of the limbal microenvironment.
Conclusions:
- Mucosal cell transplantation, especially SOMT, provides a practical and effective solution for limbal regeneration in cases of bilateral limbal deficiency.
- Ongoing surgical technique improvements are making mucosal cell transplantation more accessible and successful for ocular surface restoration.
