Authors: Nguyen, Pho; Yiu, Samuel C

Source: Expert Review of Ophthalmology, Volume 3, Number 5, October 2008 , pp. 567-584(18)

Publisher: Expert Reviews

Abstract:

Intricate homeostasis maintains the rich complexity and functionality of the ocular surface. Severe ocular surface diseases cause significant morbidities, including blindness. Ocular surface reconstruction strategies restore this homeostasis. Patients with limbal deficiency may benefit from limbal stem cell transplantation to alleviate persistent epithelial defects, maintain conjunctivalization regression and corneal avascularity, and restore vision. Amniotic membrane and other substrates function as tissue surrogates and substrates for expansion of stem cells. Maximum graft survivability necessitates aggressive and comprehensive preoperative management of inflammation, infection, microtrauma, dry eye conditions and HLA compatibility. Restoration of lacrimal gland function is important, as is implementation of aggressive immunosuppression. Future advancements in stem cell biology, tissue engineering, bioartificial microsystems or regenerative medicine will supplement the therapeutic armamentarium. The next decade will be an exciting time for corneal surgeons.

Keywords: amniotic membrane; limbal stem cell transplant; ocular surface reconstruction; patient management; prosthesis

Document Type: Research article

DOI: http://dx.doi.org/10.1586/17469899.3.5.567

Affiliations: 1: Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA., Email: pho.nguyen@usc.edu

Publication date: 2008-10-01

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