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SYMPOSIUM - TRIP
Year : 2014  |  Volume : 62  |  Issue : 1  |  Page : 29-40

Transforming ocular surface stem cell research into successful clinical practice


1 Clinical Trial Center, Dr. Paul Dubord Chair in Cornea, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
2 Cornea Services, L V Prasad Eye Institute, Bhubaneswar, India
3 Cornea and Anterior Segment Services, L V Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
4 L.V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
5 Cornea Services, L.V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
6 Sudhakar and Sreekanth Ravi Stem Cell Biology Laboratory, L.V. Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
7 Department of Materials, Science and Engineering, University of Sheffield, Sheffield, United Kingdom

Correspondence Address:
Virender S Sangwan
Clinical Trial Centre, Dr. Paul Dubord Chair in Cornea, L V Prasad Eye Institute, Hyderabad
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.126173

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It has only been a quarter of a century since the discovery of adult stem cells at the human corneo-scleral limbus. These limbal stem cells are responsible for generating a constant and unending supply of corneal epithelial cells throughout life, thus maintaining a stable and uniformly refractive corneal surface. Establishing this hitherto unknown association between ocular surface disease and limbal dysfunction helped usher in therapeutic approaches that successfully addressed blinding conditions such as ocular burns, which were previously considered incurable. Subsequent advances in ocular surface biology through basic science research have translated into innovations that have made the surgical technique of limbal stem cell transplantation simpler and more predictable. This review recapitulates the basic biology of the limbus and the rationale and principles of limbal stem cell transplantation in ocular surface disease. An evidence-based algorithm is presented, which is tailored to clinical considerations such as laterality of affliction, severity of limbal damage and concurrent need for other procedures. Additionally, novel findings in the form of factors influencing the survival and function of limbal stem cells after transplantation and the possibility of substituting limbal cells with epithelial stem cells of other lineages is also discussed. Finally this review focuses on the future directions in which both basic science and clinical research in this field is headed.


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