Department of Ocular Biology and Therapeutics, UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK.
Br Med Bull. 2011;100:209-25. doi: 10.1093/bmb/ldr041. Epub 2011 Sep 16.
Corneal opacity is a common cause of blindness. The majority of cases result from ulceration and scarring following infection or trauma, but in a proportion corneal epithelial stem cell (SC) deficiency leads to an inability to maintain a healthy corneal surface.
This review includes systematic reviews and individual case series of treatments for corneal epithelial SC deficiency.
Two techniques such as transplantation of large segments of cornea from a healthy eye and ex vivo expansion of corneal SCs in the laboratory were compared. Both have merits and their clinical outcomes are similar. The smaller biopsy in the cell expansion approach has less risk for the donor eye, which is a significant advantage.
Treatment algorithms for different aetiologies of SC failure are evolving. The proportion of true corneal epithelial SCs in ex vivo culture is unclear and it is unknown whether these cells survive long term.
In this study, the optimum method of cell culture and transplantation is being intensively investigated.
Development of tissues using multiple cell types, genetic modification to treat hereditary corneal disorders and development of cell therapy for other eye diseases are future possibilities.
角膜混浊是失明的一个常见原因。大多数病例是由感染或创伤后溃疡和瘢痕引起的，但在一定比例的情况下，角膜上皮干细胞 (SC) 缺乏会导致无法维持健康的角膜表面。
这篇综述包括治疗角膜上皮干细胞缺乏症的系统评价和个案系列。
比较了两种技术，即从健康眼睛移植大片角膜和在实验室体外扩增角膜干细胞。这两种方法都有优点，其临床结果相似。细胞扩增方法的活检较小，对供体眼的风险较小，这是一个显著的优势。
针对不同病因的干细胞衰竭的治疗方案正在不断发展。体外培养中真正的角膜上皮干细胞的比例尚不清楚，也不知道这些细胞是否能长期存活。
在这项研究中，正在深入研究细胞培养和移植的最佳方法。
使用多种细胞类型开发组织、基因修饰治疗遗传性角膜疾病以及开发用于治疗其他眼部疾病的细胞疗法，都是未来的可能性。
