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Risk factors for partial and total loss of limbal stem cells

Zarka Stoycheva, Yana Manolova, Yordan Yordanov


Introduction: In certain pathological conditions limbal stem cells are unable to function adequately - to proliferate and differentiate through their inferior capabilities to maintain corneal integrity. They are either reduced in number or have abnormal cell function. This condition is known as limbal stem cell deficiency. Depending on its severity,  limb stem cell deficiency is divided into partial (sectoral) and total diffuse. 

Aim: The purpose of this study is to investigate the risk factors for limbal stem cell deficiency. 

Material and Methods: The study included 64 patients with LSC deficiency and the risk factors for setting in and progression of the disease were evaluated using a questionnaire and clinical trials. The results were processed with SPSS v. 20 for Windows, using variation, comparative and correlation analyses, and risk assessment analysis (RR). 

Results and Discussion: As a primary risk factor wearing contact lenses that have a moderate dependence (r = 0.455; p <0.001) and carry a high risk of developing mild LSC (limbal stem cell) deficiency (RR = 13.85 (2.65 - 72.46)) stands out. A major risk factor for patients with moderate LSC deficiency are penetrating injuries that have a moderate dependence (r = 0.475; p <0.001) and significantly higher risk (RR = 15.37 (2.92 - 81.01)). In the severe form of LSC deficiency the major risk factors are chemical and thermal burns that have a significant correlation (r = 0.525; p <0.001) with severe LSC deficiency and carry an extremely high risk (RR = 12.35 (3.43 - 44.53) ) of occurring. 

Conclusion: The major risk factors for total limbal stem cell loss are chemical burns and injuries, and risk factors for partial loss are iatrogenic factors and the dry eye syndrome.


risk factors, limbal stem cell deficiency, partial and total loss of limb stem cells

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Ненкова Б, Пандова М Първична инвалидност поради слепота и слабо зрение в детска и юношеска възраст в Източна България 2005-2012г.Русе 2013г Научни трудове т 52 серия 82, с.24 ISSN 1311-3321

Ненчева Б. Зрение 20/20 мит или реалност. Варна, Стено, 2014. 135 с. ISBN: 978-619-7137-60-6, ISBN: 978-954-449-820-7

Ненчева Б. Слепота и слабо зрение в Източна България – съвременен подход. Автореферат на дисертация за присъждане на образователна и научна степен „доктор”. Варна, Медицински университет „Проф. Д-р Параскев Стоянов”, 2014

Chen JJ, Tseng SC. Corneal epithelial wound healing in partial limbal deficiency. Invest Ophthalmol Vis Sci. 1990 Jul;31(7):1301–14

Dua HS, Azuara-Blanco A. Limbal stem cells of the corneal epithelium. Surv Ophthalmol. 2000 Mar-Apr;44(5):415-25

Espana EM, Grueterich M, Romano AC, Touhami A, Tseng SCG. Idiopathic limbal stem cell deficiency. Ophthalmology. 2002 Nov;109(11):2004–10

Holland EJ. Epithelial transplantation for the management of severe ocular surface disease. Trans Am Ophthalmol Soc. 1996;94:677-743

Puangsricharern V, Tseng SC. Cytologic evidence of corneal diseases with limbal stem cell deficiency. Ophthalmology. 1995 Oct;102(10):1476-85

Tan JC, Tat LT, Coroneo MT. Treatment of partial limbal stem cell deficiency with topical interferon α-2b and retinoic acid. Br J Ophthalmol. 2016 Jul;100(7):944–8

Tseng SC. Concept and application of limbal stem cells. Eye Lond Engl. 1989;3 ( Pt 2):141–57



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