Limbal stem cell transplantation techniques

Abstract

AbstractLimbal epithelial stem cells (LSC) are essential for the regeneration of the corneal epithelium. Limbal stem cell deficiency (LSCD) that can develop in traumatic, immunologic, or genetic diseases affecting the ocular surface is a major cause of corneal transparency loss.Limbal stem cell transplantation (LSCT) aims to restore a corneal epithelial phenotype, essential to maintaining the corneal transparency. The source of donor tissue containing LSC for in vivo expansion, can be the healthy fellow eye (Conjunctivo Limbal Autograft (CLAU)), living‐related (LR) Conjunctivo Limbal Allograft or cadaveric (Kerato Limbal Allograft (KLAL)). Sheets of ex vivo expanded bioengineered epithelial cells (from autologous origin (LSC / oral mucosa) or LR (LSC) are an alternative. Before and after transplantation a proper control of the ocular surface inflammation is essential. Systemic and topical immunosuppressive treatment is also needed in all allograft recipients. In order for the surgical restoration of the corneal transparency to be complete, lamellar and penetrating keratoplasty are often required.