The role of limbal stem cells on neurotrophic cornea

Corneal innervation and corneal epithelium integrity are essential for the maintenance of ocular surface homoeostasis, which is necessary for the preservation of the overall ocular surface health. Neurotrophic keratopathy (NK) is a condition characterised by a reduction or absence of corneal sensation, while limbal stem cell deficiency (LSCD) is defined as the loss of limbal epithelial stem cells. The co-occurrence and common pathophysiological pathways of LSCD and NK necessitate the consideration of both diseases in a unified framework. Interactions between limbal stem cells and the corneal sub-basal nerve plexus, facilitated by paracrine signaling, cytokines, and growth factors, culminate in a mutualistic relationship that supports ocular surface homoeostasis. The presence of overlapping therapeutic approaches in the treatment of NK and LSCD further substantiates the interconnected nature of these two conditions. The objective of this review is to provide a summary of the interdependent relationship between the two diseases in question.