Systematic Review and Meta-analysis on Transplantation of Ex Vivo Cultivated Limbal Epithelial Stem Cell on Amniotic Membrane in Limbal Stem Cell Deficiency

Abstract

CLET is efficacious in patients with LSCD, and no difference both in success rate and visual acuity outcome between autograft and allograft was found. Overall safety profile was good, with most side effects being transient and amenable to subsequent treatments. The long-term results of autograft and allograft will inform future treatment algorithms and techniques with random control trials and better-designed analysis.

Autologous simple limbal epithelial transplantation for unilateral limbal stem cell deficiency: multicentre results

“…Baylis et al 18 and Zhao et al 19 described an improvement of two or more lines of visual acuity in 51% and 67% of eyes, respectively, with CLET. The only complication encountered in this study in significant numbers was focal recurrence of LSCD.…”

“…More recently, a meta-analysis of 572 eyes found a success rate of 67% for CLET, with no difference between results of autologous and allogeneic transplants 19. There are a few fundamental differences between SLET and CLET.…”

Ocular surface reconstruction using stem cell and tissue engineering

“…Following establishment of a suitable substrate, many researchers investigated the use of AM, fibrin and a temperature-responsive culture dish as carrier (Koizumi et al, 2000a;Nishida et al, 2004a;Rama et al, 2001;Tsai et al, 2000). From a clinical perspective, AM can serve not only as a proper epithelial carrier but also as a healthy substrate to cover a damaged ocular surface; the success of CLET using AM has been reported by a majority of groups worldwide (Baylis et al, 2011;Zhao and Ma, 2015). In addition, Sangwan has recently reported a novel surgical technique that combines AM transplantation and cultivation of small limbal explant with fibrin glue (Sangwan et al, 2012).…”

Limbal Stem Cells from Aged Donors Are a Suitable Source for Clinical Application

“…Thus, it is important both to seek new sources of stem cells with the potential to transdifferentiate to corneal epithelium [9] and to improve current allogenic transplantation techniques to resolve these issues with bilateral LSCD. Moreover, CLET grafts could also be obtained for allogenic transplantation from a living relative or from a cadaveric donor when compatible relatives are not available [10]. However, with these approaches, systemic immunosuppression is recommended to avoid tissue rejection [6].…”