Outcomes of allogeneic ocular surface stem cell transplantation

Area of Science:

• Ophthalmology
• Regenerative Medicine
• Transplantation Immunology

Background:

• Limbal stem cell deficiency (LSCD) causes ocular surface failure.
• Allogeneic ocular surface stem cell transplantation (OSST) is a key treatment for LSCD.
• Established OSST techniques include KLAL, lr-CLAL, allo-CLET, and allo-SLET.

Purpose of the Study:

• To review intermediate- and long-term outcomes of OSST for LSCD.
• To compare the efficacy and safety of different OSST techniques.
• To assess the impact of immunosuppression on OSST success.

Main Methods:

• Systematic review of 35 studies.
• Inclusion of 1,268 eyes with ≥24 months follow-up.
• Analysis of visual acuity, ocular surface stability, and complication rates.

Main Results:

• OSST generally improves visual acuity and ocular surface stability.
• Success rates range from 13% to 87% depending on the technique.
• Triple-agent immunosuppression and lr-CLAL are associated with better long-term outcomes.
• Long-term data for allo-CLET and allo-SLET are limited.

Conclusions:

• OSST is effective for LSCD, but outcomes vary significantly.
• Optimizing immunosuppression and selecting appropriate techniques are crucial.
• Further research is needed on newer OSST methods and long-term complication management.