Simple limbal epithelial transplantation slet has been proposed recently for care of total limbal stem cell deficiency. Ocular surface stem cell transplantation techniques. Limbal stem cell transplantation with amniotic membrane grafting os donor. Multiple surgical techniques for limbal stem cell transplant are currently in use yin and jurkunas, 2018. The past two decades have witnessed remarkable progress in limbal stem cell transplantation. Pdf cultivated limbal stem cell transplantationthe. In addition to harvesting stem cells from a cadaver or a live related donor, it is now possible to.
Cultivated limbal stem cell transplantationthe surgical technique. Limbal compromise results in ocular surface abnormalities characterized by chronic epithelial defects, stromal inflammation, and corneal conjunctivalization and. Available options for limbal stem cell transplantation include conjunctival limbal autograft transplantation clau, livingrelated conjunctival limbal allograft transplantation lrclal, keratolimbal allograft. Allolimbal transplantation in patients with limbal stem cell deficiency. Limbal stem cell deficiency with a pseudopterygium developed in four eyes, one treated with baresclera excision and the others with amniotic membrane transplantation. The surgical technique was similar to one described by sangwan et. Limbal stem cells, also known as corneal epithelial stem cells, are stem cells located in the basal epithelial layer of the corneal limbus.
Corneal transplantation keratoplasty is a routine, effective, and safe surgical procedure to restore the corneal transparency in the presence of. We introduce the surgical techniques, examine the success rate, and discuss the postoperative complications of conjunctival limbal autograft clau, cultivated limbal stem cell transplantation. The cornea society has proposed a classification for the various techniques of ocular surface stem cell transplantation, which is based on the following parameters. Cultivated limbal stem cell transplantationthe surgical. Ocular surface reconstruction osr is the restoration of the normal function of the ocular surface by surgical transplantation of limbal epithelial stem cells. 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. Assessment of surgical outcomes of limbal transplantation using. Limbal epithelial and mesenchymal stem cell therapy for.
While the results of the clinical trials have been extensively reported since. A new onset of glaucoma after limbal stem cell transplantation likely relates to the need for longterm topical steroidal therapy. Limbal stem cell transplantation, in isolation or in combination with other procedures, is effective in improving corneal clarity and vision. Stemcell transplantation techniques bring new cornea era. Present osst surgical techniques 15 conjunctival limbal autograft.
This means the limbal biopsy will be taken from either the limbus of a close relative or a donor eye from the cornea bank. 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. Intraoperative complications did not occur in any of the patients. Many surgical techniques are defined according to the source of the stem cells and the carrier tissues that are used. Newer techniques aim at expanding cells in vitro or in vivo in order to decrease the need for large. The cornea is responsible for protecting the eye against insults such as injury and infection. Limbal stem cell transplantation is a surgical treatment to address lscd and restore a corneal epithelial phenotype. Assessment of surgical outcomes of limbal transplantation. A variety of surgical techniques have been described to treat lscd, but cultivated limbal stem cell transplantation seems the most promising. Glaucoma after corneal limbal stem cell transplantation. Conjunctival limbal autograft clau, which involves. Based on the source of cells, limbal transplant can be autologous or allogenic. Limbal stem cell transplantation and secondary keratoplasty.
The conjunctival limbal autograft clau procedure obtains the. Clinical trials of limbal stem cell deficiency treated with. Limbal stem cell transplantation is used to restore the renewal process. Postoperatively, all patients showed corneal reepithelialization within a week.
Generation of limbal epithelium from embryonic stem. This report describes a modified surgical technique for limbal stem cell. In addition to harvesting stem cells from a cadaver or a live related donor, it is now possible to cultivate. This study describes a novel surgical technique of limbal transplantation, which combines the benefits of existing techniques while avoiding their difficulties. Limbal stem cell transplantation and complications. In the case of unilateral presentation, the procedure of choice. Surgical limbal stem cell transplantation limbal stem cell transplantation can be accomplished through several modalities. In addition to harvesting stem cells from a cadaver or a live cultivated limbal stem cell transplantation the surgical technique pdf icon download pdf. The primary goal of limbal stem cell transplantation is to restore a stable ocular surface. A stem cell bank would be established for limbal stem cell transplantation for south indian population. Ex vivo cultivated limbal stem cell transplantation is a promising technique for the treatment of limbal stem cell deficiency. Customised simple limbal epithelial transplantation for. 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. Management of unilateral limbal stem cell deficiency by.
Phenotypic study after cultivated limbal epithelial. The aim of this literature study is to summarize and. Limbal stem cell transplantation includes reconstructive surgical procedures to restore a corneal epithelium. The same procedure will be performed and you will receive an allogenic cultivated. Provide the evidence base for the proposal including literature references and other relevant. Limbal stem cell transplantation fernandes m, sangwan vs, rao. Limbal epithelial stem cells of the cornea stembook. The limbus contains stem cells which continually replenish the corneal epithelium in the physiological state. The clet technique depends on the culture of limbal biopsies to produce limbal cell sheets prior to transplantation. Surgical innovation preceded scientific understanding dr siganos noted that the use of. In summary, limbal stem cell transplantation improves both vision and.
It also provides the majority two thirds of the total refractive power of. In summary, limbal stem cell transplantation improves both vision and qualityoflife in. Six patients with unilateral and total limbal stem cell deficiency following ocular surface burns underwent a singlestage procedure. Unfortunately, the occurrence of glaucomatous optic neuropathy may lead to. Limbal stem cell transplantation northwestern scholars.649 1376 1265 252 609 985 100 1505 1258 670 1054 1125 1137 1266 244 596 1216 1597 618 842 40 1405 848 343 34 973 737 251 375 10 765 937 1148 522 1412 912 201 571