Abstract and Introduction
Abstract
Purpose of Review: With limited access of more than half the world's population to corneal transplantation, regenerative medicine may represent a promising alternative. This review explores the main advancements achieved in cell-based therapies for corneal epithelium, stroma, and endothelium during 2021–2022.
Recent Findings: Multiple surgical techniques have been developed for epithelial limbal stem cell replacement. Recent studies aimed to gain greater understanding and characterization of these techniques. Though no clear superiority could be demonstrated, simple limbal epithelial transplantation seems to have the most clinical and cost effectiveness. For stromal disease, autologous adipose-derived stem cells have shown favorable results. For endothelial dysfunction, the validity of intracameral cultivated allogeneic endothelial cell injection and Descemetorrhexis without endothelial keratoplasty, as well as the benefits of adjunctive rho-associated kinase inhibitors, were emphasized.
Summary: A plethora of innovative cell-based regenerative therapies for corneal diseases have been developed in past years. While recent literature solidifies our knowledge, most studies are still in preliminary or preclinical stages. Though showing great promise, these approaches will require larger studies with better-defined endpoints to establish their benefits over currently available treatments.
Introduction
Corneal opacification is a common cause of reversible vision loss worldwide.[1] Though full-thickness or lamellar corneal transplantations can provide a solution, only 35.7% of the world's population has sufficient access to these procedures, while 53.3% has no access at all.[2] Thus, development of other solutions warrants investigation.
Regenerative medicine for corneal disease represents an attractive alternative to keratoplasty. A widely accepted definition includes restoration of physiologic function to a defective tissue rather than replacing it. Cell-based regenerative therapies use cells, in contrast to noncellular components or drugs, to achieve this goal. There are two main approaches to cell-based therapy: one is the introduction of exogenous functioning cells, either alone or as part of an engineered tissue. The other is the manipulation of existing native cells.
Here, we focus on progress made in corneal cell-based regenerative therapies during the period 2021–2022. Though many avenues were explored, we targeted human studies with significant sample size and study quality in order to reflect techniques that may be closer to clinical application.
Curr Opin Ophthalmol. 2023;34(4):303-310. © 2023 Lippincott Williams & Wilkins
