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Stem Cells International
Volume 2016, Article ID 9798374, 22 pages
http://dx.doi.org/10.1155/2016/9798374
Review Article

Limbal Stem Cell Deficiency: Current Treatment Options and Emerging Therapies

1Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Campus Drie Eiken, T building, T4-Ophthalmology, Universiteitsplein 1, 2610 Antwerp, Belgium
2Department of Ophthalmology, Antwerp University Hospital, Dienst Oogheelkunde, Wilrijkstraat 10, 2650 Edegem, Belgium
3Research Foundation-Flanders, Egmontstraat 5, 1000 Brussels, Belgium
4Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, CCRG-Oogheelkunde, Wilrijkstraat 10, 2650 Edegem, Belgium

Received 19 June 2015; Accepted 18 August 2015

Academic Editor: Kequan Guo

Copyright © 2016 Michel Haagdorens et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Severe ocular surface disease can result in limbal stem cell deficiency (LSCD), a condition leading to decreased visual acuity, photophobia, and ocular pain. To restore the ocular surface in advanced stem cell deficient corneas, an autologous or allogenic limbal stem cell transplantation is performed. In recent years, the risk of secondary LSCD due to removal of large limbal grafts has been significantly reduced by the optimization of cultivated limbal epithelial transplantation (CLET). Despite the great successes of CLET, there still is room for improvement as overall success rate is 70% and visual acuity often remains suboptimal after successful transplantation. Simple limbal epithelial transplantation reports higher success rates but has not been performed in as many patients yet. This review focuses on limbal epithelial stem cells and the pathophysiology of LSCD. State-of-the-art therapeutic management of LSCD is described, and new and evolving techniques in ocular surface regeneration are being discussed, in particular, advantages and disadvantages of alternative cell scaffolds and cell sources for cell based ocular surface reconstruction.