Abstract
The future of eye reconstruction invariably includes stem cells transplantation. Corneal limbus, corneal stroma, trabeculum, retinal cells, optic nerve, and all structures that are irreversibly damaged and have no means to be repaired or replaced, through conventional treatment or surgery, represent targets for stem cell reconstruction. This review tries to answer the question if there is any clinical validation for stem therapies, so far, starting from the cornea and, on the path of light, arriving to the retina. The investigation covers the last 10 years of publications. From 2385 published sources, we found 56 clinical studies matching inclusion criteria, 39 involving cornea, and 17 involving retina. So far, corneal epithelial reconstruction seems well validated clinically. Enough clinical data are collected to allow some form of standardization for the stem cell transplant procedures. Cultivated limbal epithelial stem cells (CLET), simple limbal epithelial transplant (SLET), and oral mucosa transplantation are implemented worldwide. In comparison, far less patients are investigated in retinal stem reconstructions, with lower anatomical and clinical success, so far. Intravitreal, subretinal, and suprachoroidal approach for retinal stem therapies face specific challenges.
Highlights
The future of eye reconstruction invariably includes stem cells transplantation
The presence of stem cells on the ocular surface was accepted decades ago, starting with the research conducted by Davanger and Evensen, in 1971 [1], who proposed that limbal epithelial stem cells (LESC) reside in the palisades of Vogt at the limbus, at the periphery of the cornea
Between 2010 and 2020, we found 39 clinical studies regarding corneal reconstruction, matching criteria
Summary
The future of eye reconstruction invariably includes stem cells transplantation. This review tries to answer the question if there is any clinical validation for stem therapies, so far, starting from the cornea and, on the path of light, arriving to the retina. Corneal epithelial reconstruction seems well validated clinically. Far less patients are investigated in retinal stem reconstructions, with lower anatomical and clinical success, so far. Stem cells have been searched in other regions of the eye. It is not clear if neural retina or retinal pigment epithelium have any regenerative capabilities. Hematopoietic stem cells may play a role in neovascularization, as an endothelial precursor, in retinal diseases such as diabetic retinopathy [3,4]
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