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Successful simple limbal epithelial transplantation (SLET) in lime injury-induced limbal stem cell deficiency with ocular surface granuloma.

ABSTRACT: A 9-year-old boy presented with unilateral, total limbal stem cell deficiency (LSCD) complicated by the presence of a large fibro-vascular ocular surface mass lesion secondary to accidental lime injury. The pathological tissue covering the cornea was excised and simple limbal epithelial transplantation (SLET) was performed using autologous limbal tissue from the fellow eye. Histopathology of the excised ocular surface tissue revealed exuberant granulation tissue interspersed with retained calcium particles. At 6 weeks postoperatively, a focal recurrence of LSCD with symblepharon and forniceal shortening was noted superiorly. This was successfully managed by performing conjunctival autografting along with supplemental SLET. The unaided vision had improved from light perception at presentation to 20/40 at 6 months postoperatively. The fornices were deep and the corneal surface was avascular, epithelised and stable. This case demonstrates the efficacy of SLET in a child with severe ocular burns, highlighting the role of supplementary procedures customised to treat focal recurrences of LSCD.

SUBMITTER: Vazirani J

PROVIDER: S-EPMC3702880 | biostudies-other | 2013

REPOSITORIES: biostudies-other

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Successful simple limbal epithelial transplantation (SLET) in lime injury-induced limbal stem cell deficiency with ocular surface granuloma.

Vazirani Jayesh J Basu Sayan S Sangwan Virender V

BMJ case reports 20130619

A 9-year-old boy presented with unilateral, total limbal stem cell deficiency (LSCD) complicated by the presence of a large fibro-vascular ocular surface mass lesion secondary to accidental lime injury. The pathological tissue covering the cornea was excised and simple limbal epithelial transplantation (SLET) was performed using autologous limbal tissue from the fellow eye. Histopathology of the excised ocular surface tissue revealed exuberant granulation tissue interspersed with retained calciu ...[more]

PMID: 23784762

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Project description:PurposeTo propose an improved stem cell-based strategy for limbal stem cell deficiency (LSCD) treatment.DesignExperimental randomized or parallel-group animal study.SubjectsFifty adult male New Zealand white rabbits.MethodsHuman limbal stem/progenitor cells (LSCs) and limbal stromal stem/progenitor cells (LSSCs) were cultured in serum-free conditions and further differentiated into corneal epithelial cells and keratocytes, respectively. All cell types were characterized with lineage-specific markers. Gene expression analysis was performed to identify the potential function of LSSCs in corneal regeneration. Two LSCD models of rabbits for transplantations were used: transplantation performed at the time of limbal and corneal epithelial excision (LSCD model) and transplantation performed after clinical signs were induced in an LSCD model (pLSCD model). The pLSCD model better mimics the pathologic changes and symptoms of human LSCD. Rabbit models received LSC or LSC plus LSSC treatment. Corneal epithelial defects, neovascularization, and opacity were assessed every 3 weeks for 24 weeks. ZsGreen-labeled LSSCs were used for short-term tracking in vivo.Main outcome measuresRates of corneal epithelial defect area, corneal neovascularization and opacity scores, graft survival rate, and immunofluorescence staining of specific markers.ResultsBoth LSC transplantation and LSC plus LSSC cotransplantation effectively repaired the corneal surface in the LSCD model. These 2 strategies showed no significant differences in terms of graft survival rate or epithelial repair. However, corneal opacity was observed in the LSC group (in 3 of 8 rabbits), but not in the LSC plus LSSC group. Notably, when treating LSCD rabbits with distinguishable stromal opacification and neovascularization, cotransplantation of LSCs and LSSCs exhibited significantly better therapeutic effects than transplantation of LSCs alone, with graft survival rates of 87.5% and 37.5%, respectively. The implanted LSSCs could differentiate into keratocytes during the wound-healing process. RNA sequencing analysis showed that the stromal cells produced not only a collagen-rich extracellular matrix to facilitate reconstruction of the lamellar structure, but also niche factors that accelerated epithelial cell growth and inhibited angiogenesis and inflammation.ConclusionsThese findings highlight the support of stromal cells in niche homeostasis and tissue regeneration, providing LSC plus LSSC cotransplantation as a new treatment strategy for corneal blindness.

Dataset Information

Successful simple limbal epithelial transplantation (SLET) in lime injury-induced limbal stem cell deficiency with ocular surface granuloma.

Publications

Successful simple limbal epithelial transplantation (SLET) in lime injury-induced limbal stem cell deficiency with ocular surface granuloma.

Similar Datasets

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