Purpose: To present successful management of bilateral limbal stem cell deficiency (LSCD) by using an allogeneic limbal epithelial stem cell transplantation together with solid activated platelet-rich plasma (PRP).
Methods: A 59-year-old man with a history of bilateral LSCD due to penicillin-induced Stevens-Johnson Syndrome suffered from a lime corneal burn in his right eye, leading to a total LSCD with severely reduced visual acuity. After stabilizing the ocular surface, we performed an allogeneic limbal epithelial transplantation from a cadaveric donor using an autologous clot of PRP to cover the limbal grafts to nourish the ocular surface microenvironment.
Results: At the first week after the procedure, the corneal epithelium had fully reepithelized. At month 3, visual acuity improved from hand motion to 20/70.
Conclusions: In this case, this new modified procedure was a promising, easy-to-perform, apparently safe, and effective treatment option to enhanced epithelial wound healing in ocular surface diseases. To our knowledge, this is the first report describing the incorporation of solid PRP in limbal transplantation procedures.
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http://dx.doi.org/10.1097/ICO.0000000000002321 | DOI Listing |
Cornea
November 2024
External Diseases. Moorfield's Eye Hospital, London, United Kingdom.
Purpose: To describe and report the outcomes of allogeneic eccentric superficial anterior lamellar keratoplasty (SALK), a novel surgical technique, in the management of total bilateral limbal stem cell deficiency (LSCD).
Methods: Data were collected retrospectively on all patients with total bilateral LSCD who underwent SALK. Previous surgery, preexisting glaucoma, conjunctivalization, vascularization, lens status, and preoperative best-corrected visual acuity (BCVA) were collected from medical notes.
Ophthalmol Ther
February 2025
Corneoplastic Unit and Eye Bank, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
Introduction: This study compared the clinical outcomes of allogenic cultured limbal epithelial transplantation (ACLET) and cultivated oral mucosal epithelial transplantation (COMET) in the management of limbal stem cell deficiency (LSCD).
Methods: Forty-one COMET procedures in 40 eyes and 69 ACLET procedures in 54 eyes were performed in the Corneoplastic Unit of Queen Victoria Hospital, East Grinstead. Data were examined for demographics, indications, ocular surface stability, absence of epithelial defect, ocular surface inflammation, visual outcomes, and intra- and postoperative complications.
Ocul Surf
January 2025
Centre for Regenerative Medicine ''S. Ferrari'', University of Modena and Reggio Emilia, Modena, Italy. Electronic address:
Ocular vision can be hampered by corneal damages, sensibly reducing patients' quality of life and having important social and economic consequences. Ocular surface diseases, which often lead to corneal opacities with visual impairment are the most severe forms of the Limbal Stem Cell Deficiency (LSCD). The present review provides an updated perspective on the available treatments for LSCD, focusing on clinical and biological features, as well as critical points to monitor during clinical translation.
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November 2024
Department of Ophthalmology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan; Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Osaka, Japan; Premium Research Institute for Human Metaverse Medicine, Osaka University, Suita, Osaka, Japan. Electronic address:
Background: The loss of corneal epithelial stem cells from the limbus at the edge of the cornea has severe consequences for vision, with the pathological manifestations of a limbal stem-cell deficiency (LSCD) difficult to treat. Here, to the best of our knowledge, we report the world's first use of corneal epithelial cell sheets derived from human induced pluripotent stem cells (iPSCs) to treat LSCD.
Methods: This non-randomised, single-arm, clinical study involved four eyes of four patients with LSCD at the Department of Ophthalmology, Osaka University Hospital.
Bilateral limbal stem cell deficiency (LSCD) is a significant cause of corneal blindness and is more difficult to treat, as compared with unilateral LSCD because no source of autologous limbal stem cells (LSCs) remains in these patients. Thus, bilateral patients could be candidates for treatment with allogeneic LSC transplants that require long-term systemic immunosuppression therapy. Thus, if possible, for the correct candidates, using autologous LSCs could be a preferred treatment.
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