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Abstract
Abstract
Limbal Stem Cell Transplantation
Gueterich M.
University Eye Hospital, Munich, Germany
Stem cells are the ultimate source of the rapidly self-renewing corneal epithelium and are located in the basal layer of the limbal epithelium. Damage to the stem cell population causes an entity called limbal stem cell deficiency (LSCD) which is characterized by conjunctivalisation of the corneal surface. Several therapeutic strategies should be taken into account. Ocular surface defense should be restored prior to any kind of stem cell transplantation to assure a sufficient and stable tearfilm. Surgical strategies comprise superficial keratectomy with or without amniotic membrane transplantation for mild cases of LSCD. Conjunctival-limbal autograft and keratolimbal allograft transplantation are indicated in more severe cases of LSCD. A damaged limbal and corneal stroma can be restored by amniotic membrane transplantation as a biological substrate. Encouraging results have been reported using bio-engineered limbal epithelium on amniotic membrane for corneal surface reconstruction. Optimal patient selection for the respective surgical approach as well as systemic immunosuppression protocols to improve allograft survival need to be further investigated.