![]() ![]() The source of donor tissue can be autologous or allogeneic. The surgeries involving LSCT can be divided into 2 groups: grafting (direct transplantation) of limbal tissues and transplantation of cultivated LSCs. With a better understanding of the biology of LSCs and the advancement of microsurgery, substantial progress has been made in the surgical management of LSCD. 2 For eyes with severe or total LSCD, limbal stem cell transplantation (LSCT) is necessary to restore the population of LSCs. Medication is only effective in partial LSCD. ![]() ![]() Keratoplasty will fail if the normal function of LSCs is not restored first. Limbal stem cell deficiency (LSCD) is an ocular surface disease caused by a decrease in the population and/or function of limbal epithelial stem cells (LSCs), which leads to the inability to sustain the normal homeostasis of the corneal epithelium. Patients who underwent ALLT had the highest rate of recurrent epithelial erosion (27.8% 95% CI, 17.1%-41.9%) and intraocular pressure elevation (6.3% 95% CI, 1.8%-19.4%).Ĭonclusions and Relevance These findings suggest LSCT can improve or stabilize the corneal surface with a low rate of severe ocular complications and that autologous LSCT may have a higher success rate and fewer complications than allogenic LSCT. The most common adverse events in all recipient eyes were recurrent/persistent epithelial erosion (10.5% 95% CI, 7.2%-23.3%) and elevated intraocular pressure (intraocular pressure, 1.7% 95% CI, 0.5%-7.8%). Autologous limbal transplantation resulted in a greater VA improvement rate (76%) than did the other 3 procedures (cAULT: 56.4% ALLT: 52.3% cALLT: 43.3% all P < .001). The number of eyes that underwent AULT, ALLT, cAULT, and cALLT were 505, 742, 771, and 184, respectively. The mean (SD) age of study participants was 38.4 (13.1) years, and men accounted for 74%. Results Forty studies (2202 eyes) with a mean (SD) follow-up of 31.3 (20.9) months met the inclusion criteria. Main Outcomes and Measures Outcome measures included the improvement of ocular surface, visual acuity (VA), and adverse events of recipient eyes and donor eyes. Heterogeneity was evaluated with the I 2 statistic, and a meta-analysis was performed using the random-effects model. Animal studies and studies of other surgical interventions were excluded.ĭata Extraction and Synthesis Two reviewers independently abstracted the data from each study. Study Selection Clinical studies with the outcome of at least 20 eyes after LSCT were included. The latest search was performed on June 30, 2019. Objective To evaluate the outcomes of different LSCT procedures.ĭata Source We searched PubMed, EMBASE, Web of Science, and Cochrane without language filter for peer-reviewed articles about LSCT. To our knowledge, there is no study directly comparing the outcomes and complications of these procedures. Importance Limbal stem cell transplant (LSCT) can be categorized as direct autologous limbal transplant (AULT), direct allogenic limbal transplant (ALLT), cultivated autologous limbal stem cells transplant (cAULT), and cultivated allogenic limbal stem cells transplant (cALLT). Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]()
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