Topical application of autologous adipose‐derived mesenchymal stem cells (AdMSCs) for persistent sterile corneal epithelial defect

Abstract

AbstractPurpose To report a patient with post‐traumatic persistent sterile corneal epithelial defect treated with topical application of autologous AdMSCs.Methods A 35‐yr‐old man was referred to our clinic for treatment of post‐traumatic persistent corneal epithelial defect previously treated as infection. 1 yr before CxL was performed for keratoconus stabilization. Examination showed a central corneal epithelial defect with stromal opacification and thinning. Corneal sensitivity was decreased, while corneal scraping cultures were negative for bacterial or fungal infection. Despite conventional treatment (patching, artificial tears, soft contact lens & autologous serum) no corneal epithelial healing progress occurred 50 days after injury. A PKP was scheduled due to risk of corneal perforation. While waiting for graft, we proposed to the patient the alternative treatment of autologous AdMSCs. IRB was obtained and approved from the Hospital.Results Corneal epithelial healing process was started 10 days after topical application of MSCs, isolated through liposuction. 1 month later, complete corneal epithelial healing was observed. 1 yr later, corneal epithelium remained intact with mild anterior stromal opacification. The patient’s current UCVA lies between 6‐7/10.Conclusion Topical application of autologous adipose‐derived MSCs seems to promote corneal epithelial healing in a patient with persistent sterile corneal epithelial defect refractory to other treatments. Differentiation or trans‐differentiation of MSCs into corneal epithelial/stromal cells and/or production of trophic factors could be possible mechanisms behind the corneal healing process.