Global Consensus on the Management of Limbal Stem Cell Deficiency
| Autor: | Shigeru Kinoshita, Friedrich E. Kruse, Donald T.H. Tan, Reza Dana, Virender S Sangwan, Paolo Rama, Allan R. Slomovic, Sheraz M. Daya, Clara C. Chan, Francisco C Figueiredo, José Álvaro Pereira Gomes, Sophie X. Deng |
|---|---|
| Přispěvatelé: | Deng, S. X., Kruse, F., Gomes, J. A. P., Chan, C. C., Daya, S., Dana, R., Figueiredo, F. C., Kinoshita, S., Rama, P., Sangwan, V., Slomovic, A. R., Tan, D. |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
conjunctiva Keratoprosthesis Cell Transplantation Visual Acuity Limbus Corneae Global Health Transplantation Autologous Conjunctival Diseases Corneal Diseases Limbal stem cell deficiency 03 medical and health sciences 0302 clinical medicine Scleral lens stem cells cornea Cornea medicine Humans Transplantation Homologous Surgical treatment limbal stem cells Cells Cultured treatment business.industry Stem Cells Mouth Mucosa Epithelial Cells limbal stem cell deficiency Surgery Transplantation Ophthalmology medicine.anatomical_structure Eyelid Diseases 030221 ophthalmology & optometry sense organs Eyelid Stem cell business 030217 neurology & neurosurgery Stem Cell Transplantation |
| Zdroj: | Cornea. 39:1291-1302 |
| ISSN: | 0277-3740 |
| DOI: | 10.1097/ico.0000000000002358 |
| Popis: | Purpose In recent decades, the medical and surgical treatment of limbal stem cell deficiency (LSCD) has evolved significantly through the incorporation of innovative pharmacological strategies, surgical techniques, bioengineering, and cell therapy. With such a wide variety of options, there is a need to establish a global consensus on the preferred approaches for the medical and surgical treatment of LSCD. Methods An international LSCD Working Group was established by the Cornea Society in 2012 and divided into subcommittees. Four face-to-face meetings, frequent email discussions, and teleconferences were conducted since then to reach agreement on a strategic plan and methods after a comprehensive literature search. A writing group drafted the current study. Results A consensus in the medical and surgical management of LSCD was reached by the Working Group. Optimization of the ocular surface by eyelid and conjunctival reconstruction, antiinflammatory therapy, dry eye and meibomian gland dysfunction treatment, minimization of ocular surface toxicity from medications, topical medications that promote epithelialization, and use of a scleral lens is considered essential before surgical treatment of LSCD. Depending on the laterality, cause, and stage of LSCD, surgical strategies including conjunctival epitheliectomy, amniotic membrane transplantation, transplantation of limbal stem cells using different techniques and sources (allogeneic vs. autologous vs. ex vivo-cultivated), transplantation of oral mucosal epithelium, and keratoprosthesis can be performed as treatment. A stepwise flowchart for use in treatment decision-making was established. Conclusions This global consensus provides an up-to-date and comprehensive framework for the management of LSCD. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|