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F. C. Figueiredo, S. Ahmad, M. Lako, S. Kolli; Outcomes of ex vivo Expanded Limbal Stem Cell Transplantation in Humans. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1793.
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To study the clinical outcome of transplanting animal-free cultivated limbal epithelial cells on human amniotic membrane (AM) for the treatment of patients with limbal stem cell deficiency (LSCD).
Prospective, single-centre, noncomparative, interventional case series.
Seven of the patients were male and the mean age was 43 (range 16 - 73). Mean follow up was 18 months (range 8 - 31). Postoperatively, satisfactory ocular surface reconstruction was obtained in all eyes (100%), as confirmed by IC. However, three of the eight eyes developed localised conjunctival invasion, requiring subsequent sectoral epitheliectomy. Penetrating keratoplasty was performed in 1 eye. At last examination, visual acuity improved in 5 eyes and remained unchanged in 3 eyes. Vision impairment and pain scores improved in all patients (p<0.05). Complications: ocular surface exposure that required lid surgery in 1 eye and corneal graft rejection in 1 eye.
This study demonstrates thattransplantation of autologous limbal epithelial stem cells cultured on amniotic membrane without the use of animal cells or products is an effective method of reconstructing the corneal surface and restoring useful vision in patients with unilateral LSCD. This procedure has the potential to become a viable management option for patients with severe LSCD but it requires more resources. Further studies with more patients and longer follow-up should be conducted.
Clinical Trial: :
National Research Ethics Service: 2002/280
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