Limbal stem cell transplantation is a surgical treatment for severe ocular surface disease where the cornea has lost its normal stem cells, leading to persistent defects, scarring, and conjunctival overgrowth. The procedure restores a healthy population of stem cells at the limbus.
Sources of Stem Cells
Grafts can be taken from the patient’s fellow eye (autograft) when it is healthy, or from donor tissue or cultivated cells (allograft) when both eyes are affected. Techniques include conjunctival-limbal autograft, simple limbal epithelial transplantation, and cultivated limbal epithelial transplantation.
- The graft is secured to the diseased eye after removing abnormal tissue
- Amniotic membrane is often used as a scaffold and to promote healing
- Allogeneic procedures require systemic immunosuppression to prevent rejection
- Patient selection and pre‑operative optimisation of the ocular surface are critical
Outcomes and Care
Successful transplantation can restore a stable, clear corneal epithelium, allowing later optical procedures such as keratoplasty or improving vision directly. Long-term follow‑up and adherence to medication are essential.
- Complications include graft failure, rejection, infection, or recurrence of disease
- Systemic side effects from immunosuppressants must be monitored
- Protection from further chemical or mechanical injury helps preserve the graft
- Rehabilitation may involve scleral lenses or additional surgery for best visual function
