Limbal stem cell deficiency in inflammatory disorders

Limbal stem-cell deficiency (LSCD) is a disease characterized by persistent or recurrent epithelial defects, chronic inflammation, and conjunctiva migration onto the cornea (conjunctivalization) with severe visual impairment. Lamellar and/or penetrating keratoplasty cannot be successful as donor corneal epithelium is replaced by that of the recipient within months. In the presence of LSCD graft re-epithelialisation will not take place, with subsequent recurrence of conjunctivalization and graft failure. Stem-cell transplantation to treat LSCD is a step in the reconstruction of the ocular surface, while lamellar or penetrating corneal grafting will finally restore corneal transparency, leading to the recovery of visual capacity. The source of stem cells is typically classified as autologous and allogeneic. Unilateral or partial bilateral LSCDs can be treated with autologous limbal stem cell transplantation, while total bilateral deficiency requires allogeneic LSCs, or other sources of autologous cells such as oral epithelial stem cells.