Homologous penetrating central limbo‐keratoplasty (HPCLK) in bilateral limbal stem cell insufficiency

Reinhard, Thomas; Sundmacher, Rainer; Spelsberg, Helga; Althaus, Christoph

doi:10.1034/j.1600-0420.1999.770611.x

Cited by 49 publications

(28 citation statements)

References 16 publications

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“…In cases with bilateral limbal stem cell deficiency, homologous limbal grafts are necessary, with keratoplasty as a second step or homologous penetrating central limbo‐keratoplasty in one step (Kenyon & Tseng 1989; Reinhard et al. 1999).…”

Section: Introductionmentioning

confidence: 99%

Corneal surface reconstruction using adult mesenchymal stem cells in experimental limbal stem cell deficiency in rabbits

Reinshagen¹,

Auw-Haedrich²,

Sorg

et al. 2009

Acta Ophthalmologica

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106

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ABSTRACT.Purpose: To investigate the ability of mesenchymal stem cells (MSC) to transdifferentiate to corneal epithelial cells in experimental limbal stem cell deficiency in rabbits. Methods: Total limbal stem cell deficiency was produced in 21 right eyes of 21 New Zealand rabbits; 6 eyes served as controls (group 1, G1). After removal of the conjunctival overgrowth, five eyes received amniotic membrane transplantation (AMT; G2). In four eyes, autologous limbal stem cell transplantation from the healthy eye was performed with AMT (G3). In another six eyes, enriched autologous MSC were injected under the amniotic membrane (AM) (G4). Within 280 days, corneoscleral discs were analysed for goblet cells, cytokeratin (CK) 3 ⁄ 12, connexin 43, b 1 -integrin, CK 19, a-enolase, p63 and ATP-binding cassette transporter subtype G-2 (ABCG-2) distribution patterns. Results: Cultivated MSC were positive for CK 3 ⁄ 12 and a-enolase, but negative for ABCG-2, p63 and connexin 43. On rabbit corneas, CK 3 ⁄ 12 was expressed in all corneal regions in all groups, but with significantly different intensities. Among all other parameters, expression levels of ABCG-2, b 1 -integrin and connexin 43 were significantly different between the transplanted groups and the control group. After a mean follow-up time of 172 (47-280) days, goblet cells were rarely present in the central cornea (G1-4). Conclusion: CK 3 ⁄ 12 is not highly specific for differentiated corneal epithelium. Further, goblet cells are not a reliable marker for conjunctivalization in rabbits. Expression of ABCG-2, b 1 -integrin and connexin 43 after mesenchymal stem cell transplantation may indicate their ability to maintain their stem cell character or to transdifferentiate to epithelial progenitor cells.

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Section: Introductionmentioning

confidence: 99%

Corneal surface reconstruction using adult mesenchymal stem cells in experimental limbal stem cell deficiency in rabbits

Reinshagen¹,

Auw-Haedrich²,

Sorg

et al. 2009

Acta Ophthalmologica

Self Cite

106

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“…Allogeneic transplantation techniques such as keratolimbal allograft, or KLAL, 13 living-related conjunctival autograft, 14 and homologous penetrating central limbo-keratoplasty (HPCLK) 15 have been studied for several years with varying levels of success. The downsides of allogeneic transplantation include the inherent risks of immune rejection, and the cost and potential complications of lifelong or, at minimum, prolonged immunosuppression.…”

Section: Allogeneic Sctmentioning

confidence: 99%

Autologous Limbal Stem Cell Transplantation: The Progression of Diagnosis and Treatment

Khan-Farooqi

Chodosh

2016

Seminars in Ophthalmology

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Though the corneoscleral limbus has been studied for more than 150 years, our ability to successfully treat those with limbal stem cell deficiency (LSCD) is still a work in progress. Today, the only definitive cure for LSCD is stem cell transplantation. This review briefly discusses the evolution of our understanding of limbal stem cell function, provides an outline of the history of autologous limbal stem cell (LSC) transplantation, and discusses current techniques and future strategies for LSCD treatment.

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“…To date, it appears that the long-term survival of PKP is uncertain, owing to increasing risks of graft rejection, non-rejection related failures and/or recurrent surface disorder, whenever PKP is performed with or without LSCT [139,140]. Unfortunately, the existing clinical series that discuss corneal grafts and/or LSCT are, in general, small and have varying degrees of follow-up [15,61,102,112,[141][142][143][144][145][146][147][148][149][150][151][152][153][154][155]. This limits our ability to draw any valid conclusions from these studies about which surgical technique of LSCT and immunosuppressive therapy are optimal.…”

Section: Perform Corneal Transplantation With or Without Limbal Stem mentioning

confidence: 99%

Graft failure: II. Ocular surface complications

Al-Swailem

2007

Int Ophthalmol

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Risk factors for corneal transplantation failure include both immunologic factors, such as graft rejection, corneal neovascularization, and peripheral anterior synechiae, as well as non-immunologic factors, such as ocular surface disorders (OSD) and glaucoma. This review highlights the necessity of having healthy ocular surface epithelia, tears, and eyelids. It presents different types of OSD, their underlying pathology, and their impact on native cornea and corneal grafts. In addition, a range of proposed donor and surgical factors influencing surface integrity following corneal transplant are addressed. Current medical and surgical research, both pre- and post-operative that promise to further improve the outcome of corneal grafts in the context of OSD are discussed.

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Homologous penetrating central limbo‐keratoplasty (HPCLK) in bilateral limbal stem cell insufficiency

Abstract: ABSTRACT.Purpose: Bilateral stem cell deficiency can be overcome only by keratoplasty plus additional homologous limbal transplantation. We have four years' experience with a new surgical one-stage procedure, homologous penetrating central limbo-keratoplasty (HPCLK).

Cited by 49 publications

References 16 publications

Corneal surface reconstruction using adult mesenchymal stem cells in experimental limbal stem cell deficiency in rabbits

Corneal surface reconstruction using adult mesenchymal stem cells in experimental limbal stem cell deficiency in rabbits

Autologous Limbal Stem Cell Transplantation: The Progression of Diagnosis and Treatment

Graft failure: II. Ocular surface complications

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