Genetic analysis of allogenic donor cells after successful allo-limbal epithelial transplantation in simple and cultivated limbal epithelial transplantation procedures

Midterm results after allogeneic simple limbal epithelial transplantation from deceased-donor eyes in patients with persistent corneal epithelial defects due to limbal stem cell deficiency

BACKGROUND

This study aims to characterize the clinical outcomes after allogeneic simple limbal epithelial transplantation (alloSLET) utilizing tissue from cadaveric donor eyes to address persistent corneal epithelial defects caused by limbal stem cell deficiency.

METHODS

We conducted a retrospective analysis of medical records from 20 patients, encompassing 24 eyes, who underwent alloSLET at least 2 years prior. The primary endpoint was the achievement of complete epithelialization of the corneal surface by corneal epithelium. Secondary endpoints included corrected distance visual acuity (CDVA) and postoperative adverse events.

RESULTS

The median postoperative follow-up period was 36 months (range, 24-74 months). At 1, 3 and 6 months post-surgery, 96% of eyes demonstrated epithelialized corneal surfaces, which declined to 71% at 12 months, to 54% at 24 and 36 months after surgery, and to 50% thereafter. There were no significant differences in graft survival between alloSLET performed alone versus in combination with penetrating keratoplasty. However, instances of graft failure were associated with postoperative elevated intraocular pressure (IOP) and a history of multiple amniotic membrane and corneal graft transplants.

CONCLUSIONS

AlloSLET emerges as a viable mid-term intervention for limbal stem cell deficiency-associated non-healing corneal epithelial defects in the absence of autologous limbal tissue. Our findings underscore the increased risk of graft failure in patients with elevated IOP and a background of multiple previous amniotic membrane and corneal graft procedures.

Comparative analysis of long-term results of three epithelial cell transplantation procedures for treating limbal stem cell deficiency

This study compared the long-term outcome of different epithelial transplantation techniques to treat limbal stem cell deficiency (LSCD). We conducted a retrospective 15-year comparative systematic cohort study of patients with LSCD who underwent either cultivated limbal epithelial transplantation (CLET), simple limbal epithelial transplantation (SLET), or cultivated oral mucosal epithelial transplantation (COMET). We reviewed the demographic data, etiology, LSCD severity, best-corrected visual acuity, surgical outcomes, and complications. A total of 103 eyes of 94 patients (mean age, 45.0 ± 16.4 years) with LSCD were enrolled. The most common cause of LSCD was chemical injury (42.7 %). The median follow-up time was 75 months. The success rates of CLET, SLET, and COMET were 45.5 %, 77.8 %, and 57.8 %, respectively. The 7-year survival rates after CLET, SLET, and COMET were 50.0 %, 72.2 %, and 53.2 %, respectively. Steven-Johnson syndrome (SJS) had a significantly lower survival rate than other causes (p < 0.001), but SLET had a significantly higher survival rate than CLET (p = 0.018) and COMET (p = 0.047). Visual improvement of more than four Snellen lines was achieved in 53.1 % of successful cases and 28.2 % of failed cases. SJS, Schirmer I test <5 mm, and the presence of postoperative recurrent epithelial defects were significant risk factors for a failed surgery. All epithelial transplantation techniques had favorable long-term surgical outcomes. More than half of the patients achieved a stable ocular surface and visual acuity improvement up to 7 years postoperatively. SLET tends to have a better surgical outcome than CLET and COMET, especially in patients with SJS.

Unlocking the versatile potential: Adipose-derived mesenchymal stem cells in ocular surface reconstruction and oculoplastics

This review comprehensively explores the versatile potential of mesenchymal stem cells (MSCs) with a specific focus on adipose-derived MSCs. Ophthalmic and oculoplastic surgery, encompassing diverse procedures for ocular and periocular enhancement, demands advanced solutions for tissue restoration, functional and aesthetic refinement, and aging. Investigating immunomodulatory, regenerative, and healing capacities of MSCs, this review underscores the potential use of adipose-derived MSCs as a cost-effective alternative from bench to bedside, addressing common unmet needs in the field of reconstructive and regenerative surgery.