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Ocular Surface Reconstruction

The eye’s cornea is a clear tissue that allows light to enter the eye, and refracts light rays to focus onto the retina. The cornea’s outermost section, the epithelial layer, acts as a protective barrier against germs and dust.

Between the cornea and the sclera, the eyeball’s white outer coating, is the limbus, where some important cells reside. Limbal stem cells are the “mother cells” that give rise to corneal epithelial cells. Severe damage to the limbal stem cells from whatever the cause, impairs a person’s vision.

When the outer eye surface is destroyed and if the limbus is damaged, the corneal surface becomes populated by abnormal epithelial cells. Without the proper epithelials, the cornea’s surface is no longer smooth, but can become cloudy or scars, significantly affecting the person’s ability to see.

Industrial injuries, Stevens-Johnson Syndrome, certain inflammatory diseases, or wearing poorly fitting contact lenses can over time damage the supply of limbal stem cells. Ocular surface reconstruction, or limbal stem cell transplantation, can transplant healthy stem cells from the patient’s unaffected eye, or from a living donor to the diseased eye.

During an outpatient procedure, which lasts about an hour, some limbal stem cells are taken from the healthy eye or a donor’s eye and transplanted to the affected eye. If the transplant is successful, the limbal stem cells will produce a new layer of epithelial cells in the patient’s eye. The success rate from transplanted limbal stem cells ranges from 25% to 70%, depending on the underlying condition of the eye.

In some cases, the transplant alone can considerably improve a patient’s vision. In other patients, it provides the basis for a cornea transplant. If the limbus is healthy, the cornea transplant will usually be successful. However, transplants will fail without the presence of healthy limbal stem cells.

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Copyright 2013 Washington University School of Medicine
Copyright 2013 Washington University School of Medicine