Cultivated Limbal Stem Cell Transplantation: Indications and Technique
Authors
Joséphine Behaegel, Sorcha Ní Dhubhghaill, Marie-José Tassignon
Institution
University of Antwerp
Country
Belgium
Year
2019
Journal
Corneal Regeneration: Therapy and Surgery (Essentials in Ophtalmology)
Abstract
Advances in stem cell research have made revolutionary changes to healthcare and medicine, holding promise for the restoration and regeneration of dysfunctional cells for a wide range of diseases and injuries. Ophthalmology stands at the forefront of this new technology with cultivated limbal epithelial transplantation (CLET) as a prime example of these cell-based therapies. CLET aims to restore the ocular surface in stem cell-deficient eyes by transplanting ex vivo expanded stem cell grafts. Cells are harvested from a healthy limbus, grown and multiplied in a laboratory for several days and then transplanted onto the stem cell-deficient eye. Since the introduction of this technique in 1997, numerous cultivation methods and surgical approaches have been used in various centres worldwide. In the majority of cases, the technique has been shown to successfully regenerate the corneal epithelium.
While the cell products produced by the laboratory continue to improve, it is also important to consider the recipient ocular surface as the recipient bed plays a crucial role in the survival of composite graft and the success of the surgery.
In this chapter, we explore indications for CLET, define preoperative evaluation and preparation methods and describe the cultivation and surgical approach based on our >10-year experience with this technique.