Stem cell culture for limbal deficiency

Purpose Cultured stem cell transplantation is a new promising technology for eye diseases associated with destruction, dysfunction, or genetic abnormalities of ocular stem cells. The first group of ocular diseases targeted is limbal stem cell deficiency. Various ocular disorders, including ocular burns, Stevens‐Johnson syndrome, cicatricial ocular pemphigoid, severe infectious keratitis, contact lens‐induced keratopathy, multiple surgical procedures involving the limbal region, aniridia, congenital erythrokerato‐dermia, and keratitis associated with multiple endocrine deficiencies, may induce limbal deficiency. Methods Various culture techniques have been developed that can be classified according to the type of stem cells (limbal epithelium or oral mucosal epithelium), the source of stem cells (autologous or allogeneic), the type of culture (explants or dissociated cells, feeders or no feeders), the carrier used to grow cells (amniotic membrane, fibrin, temperature‐responsive plastic), and culture media. Eye banks are often involved in the preparation of these cell therapy products. Results Prospective clinical trials have shown that transplantation of cultured epithelial stem cells improves the ocular surface condition of patients with limbal deficiency with a high success rate, especially when autologous limbal stem cells can be used as the source of cultured cells. Conclusion However, many issues are still to be investigated. Among them, selection and screening of donor tissue, microbiological safety of stem cell production process, safety of transplantation of cells cultured with products or feeder cells from animal origin, choice of the best technology to be used for growing stem cells, evaluation of the cell therapy product before transplantation, definition of success after transplantation.