Shaping the Future of Limbal Stem Cell Therapy: Advances in Substrates, Techniques, and Science for Cultivated Autologous and Allogeneic Limbal Epithelial Transplantation.

Abstract

Limbal stem cell deficiency (LSCD) is a rare but often progressive condition associated with significant ocular morbidity and visual loss. LSCD can be partial or total and can affect one or both eyes, important factors to consider when planning disease management. Decades of laboratory and clinical research have provided the basis for the contemporary understanding and management of this condition. In this narrative review, we highlight the important breakthroughs in limbal stem cell science which have shaped limbal stem cell therapy, current cell culture techniques, and the respective merits of the substrates used. We outline the key management principles in the treatment of LSCD, where a multi-disciplinary approach is essential in optimizing outcomes, and describe the current clinical and surgical options available. We also explore the emerging treatments on the horizon.