A new onset of glaucoma after limbal stem cell transplantation likely relates to the need for longterm topical steroidal therapy. We introduce the surgical techniques, examine the success rate, and discuss the postoperative complications of conjunctival limbal autograft clau, cultivated limbal stem cell transplantation. Limbal stem cell transplantation, in isolation or in combination with other procedures, is effective in improving corneal clarity and vision. Unfortunately, the occurrence of glaucomatous optic neuropathy may lead to. Assessment of surgical outcomes of limbal transplantation using.
Limbal compromise results in ocular surface abnormalities characterized by chronic epithelial defects, stromal inflammation, and corneal conjunctivalization and. Limbal stem cell deficiency lscd is a clinical condition characterized by damage of cornea limbal stem cells, which results in an impairment of corneal epithelium turnover and in an invasion of the cornea by. The cornea society has proposed a classification for the various techniques of ocular surface stem cell transplantation, which is based on the following parameters. The same procedure will be performed and you will receive an allogenic cultivated.
Ocular surface stem cell transplantation techniques. The limbus contains stem cells which continually replenish the corneal epithelium in the physiological state. Available options for limbal stem cell transplantation include conjunctival limbal autograft transplantation clau, livingrelated conjunctival limbal allograft transplantation lrclal, keratolimbal allograft. A variety of surgical techniques have been described to treat lscd, but cultivated limbal stem cell transplantation seems the most promising. In addition to harvesting stem cells from a cadaver or a live related donor, it is now possible to cultivate.
Management of unilateral limbal stem cell deficiency by. In addition to harvesting stem cells from a cadaver or a live cultivated limbal stem cell transplantation the surgical technique pdf icon download pdf. Limbal stem cell transplantation with amniotic membrane grafting os donor. Limbal stem cell transplantation northwestern scholars. Limbal stem cells, also known as corneal epithelial stem cells, are stem cells located in the basal epithelial layer of the corneal limbus. The past two decades have witnessed remarkable progress in limbal stem cell transplantation. The clet technique depends on the culture of limbal biopsies to produce limbal cell sheets prior to transplantation.
Clinical trials of limbal stem cell deficiency treated with. In summary, limbal stem cell transplantation improves both vision and. Phenotypic study after cultivated limbal epithelial. Stemcell transplantation techniques bring new cornea era. In addition to harvesting stem cells from a cadaver or a live related donor, it is now possible to. It also provides the majority two thirds of the total refractive power of. Conjunctival limbal autograft clau, which involves. The aim of this literature study is to summarize and.
Assessment of surgical outcomes of limbal transplantation. Ex vivo cultivated limbal stem cell transplantation is a promising technique for the treatment of limbal stem cell deficiency. This means the limbal biopsy will be taken from either the limbus of a close relative or a donor eye from the cornea bank. Provide the evidence base for the proposal including literature references and other relevant. Limbal stem cell deficiency lscd is characterized by loss of limbal palisades of vogt, ingrowth of conjunctiva on to the cornea, and recurrent or persistent epithelial defects of the cornea.
Limbal epithelial and mesenchymal stem cell therapy for. The primary goal of limbal stem cell transplantation is to restore a stable ocular surface. Corneal transplantation keratoplasty is a routine, effective, and safe surgical procedure to restore the corneal transparency in the presence of. Customised simple limbal epithelial transplantation for. Limbal stem cell transplantation is used to restore the renewal process. Limbal epithelial and mesenchymal stem cell therapy for corneal regeneration sachin shukla a, swapna s shanbhagb, fatemeh tavakkoli, shobhit varmab, vivek singha, and sayan basua,b acenter. Many surgical techniques are defined according to the source of the stem cells and the carrier tissues that are used. In this technique a small biopsy is harvested from healthy. While the results of the clinical trials have been extensively reported since. A stem cell bank would be established for limbal stem cell transplantation for south indian population.
This study describes a novel surgical technique of limbal transplantation, which combines the benefits of existing techniques while avoiding their difficulties. Postoperatively, all patients showed corneal reepithelialization within a week. The conjunctival limbal autograft clau procedure obtains the. Limbal stem cell transplantation fernandes m, sangwan vs, rao.
Six patients with unilateral and total limbal stem cell deficiency following ocular surface burns underwent a singlestage procedure. Cultivated limbal stem cell transplantationthe surgical. Simple limbal epithelial transplantation slet has been proposed recently for care of total limbal stem cell deficiency. In the case of unilateral presentation, the procedure of choice. Pdf cultivated limbal stem cell transplantationthe. The surgical technique was similar to one described by sangwan et. Multiple surgical techniques for limbal stem cell transplant are currently in use yin and jurkunas, 2018. In summary, limbal stem cell transplantation improves both vision and qualityoflife in. Generation of limbal epithelium from embryonic stem. Glaucoma after corneal limbal stem cell transplantation.
Allolimbal transplantation in patients with limbal stem cell deficiency. Limbal stem cell transplantation and complications. Intraoperative complications did not occur in any of the patients. Newer techniques aim at expanding cells in vitro or in vivo in order to decrease the need for large. Limbal stem cell transplantation is a surgical treatment to address lscd and restore a corneal epithelial phenotype.
Based on the source of cells, limbal transplant can be autologous or allogenic. This report describes a modified surgical technique for limbal stem cell. Cultivated limbal stem cell transplantationthe surgical technique. Surgical limbal stem cell transplantation limbal stem cell transplantation can be accomplished through several modalities. Limbal stem cell transplantation includes reconstructive surgical procedures to restore a corneal epithelium. Limbal stem cell deficiency with a pseudopterygium developed in four eyes, one treated with baresclera excision and the others with amniotic membrane transplantation. Limbal epithelial stem cells of the cornea stembook. Present osst surgical techniques 15 conjunctival limbal autograft. Surgical innovation preceded scientific understanding dr siganos noted that the use of. Limbal stem cell transplantation and secondary keratoplasty. Ocular surface reconstruction osr is the restoration of the normal function of the ocular surface by surgical transplantation of limbal epithelial stem cells. The cornea is responsible for protecting the eye against insults such as injury and infection.
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