Transplantation of ex vivo expanded limbal stem cells in neurotrophic keratopathy - a case report

R. Hristova; Y. Zdravkov; M. Hristova; I. Tanev

doi:10.14748/bro.v0i4.4557

Transplantation of ex vivo expanded limbal stem cells in neurotrophic keratopathy - a case report

R. Hristova, Y. Zdravkov, M. Hristova, I. Tanev

Abstract

We present a case of neurotrophic keratopathy associated with limbal stem cell deficiency, treated by transplantation of autologous ex vivo expanded limbal stem cells. The applied diagnostic methods include slit-lamp examination, microbiological samples from conjunctiva and corneal lesion, polymerase chain reaction of aqueous humor for herpes virus DNA, anterior segment optical coherence tomography. Since no improvement was observed with conservative treatment, a minimally invasive limbal biopsy and transplantation of amniotic membrane were performed. The collected autologous limbal stem cells were expanded ex vivo using an innovative protocol without xenobiotic products on intact amniotic membrane. After sufficient epithelial layers were obtained ex vivo the graft was transplanted on the ocular surface of the patient. Postoperatively the corneal surface was completely covered by epithelium, visual acuity improved significantly. Regression of neovascular vessels was observed and all symptoms of chronic inflammation were alleviated. Transplantation of ex vivo expanded limbal stem cells on amniotic membrane can be an effective treatment method for neurotrophic keratopathy, associated with limbal stem cell deficiency.

Keywords

Transplantation; limbal stem cells; neurotrophic keratopathy; limbal stem cell deficiency

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DOI: http://dx.doi.org/10.14748/bro.v0i4.4557