Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment
The use of advanced therapies with stem cells to reconstruct the complex tissue of corneal stroma has gained interest in recent years. Besides, collagen-based scaffolds bioengineering has been offered as another alternative over the last decade. The outcomes of the first clinical experience with ste...
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| Format: | Article |
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Frontiers Media S.A.
2021-02-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.650724/full |
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| author | Mona El Zarif Mona El Zarif Mona El Zarif Mona El Zarif Jorge L. Alió Jorge L. Alió Jorge L. Alió del Barrio Jorge L. Alió del Barrio Maria P. De Miguel Karim Abdul Jawad Nehman Makdissy |
| author_facet | Mona El Zarif Mona El Zarif Mona El Zarif Mona El Zarif Jorge L. Alió Jorge L. Alió Jorge L. Alió del Barrio Jorge L. Alió del Barrio Maria P. De Miguel Karim Abdul Jawad Nehman Makdissy |
| author_sort | Mona El Zarif |
| collection | DOAJ |
| description | The use of advanced therapies with stem cells to reconstruct the complex tissue of corneal stroma has gained interest in recent years. Besides, collagen-based scaffolds bioengineering has been offered as another alternative over the last decade. The outcomes of the first clinical experience with stem cells therapy on corneal stroma regeneration in patients with advanced keratoconus were recently reported. Patients were distributed into three experimental groups: Group 1 (G-1) patients underwent implantation of autologous adipose-derived adult stem cells (ADASCs) alone, Group 2 (G-2) received a 120 μm decellularized donor corneal stromal laminas, and Group 3 (G-3) received a 120 μm recellularized donor laminas with ADASCs. A follow up of 36 months of clinical data, and 12 months of confocal microscopy study was performed, the authors found significant clinical improvement in almost all studied mean values of primary and secondary outcomes. Corneal confocal microscopy demonstrated an increase in cell density in the host stroma, as well as in the implanted tissue. Using different approaches, allogenic small incision lenticule extraction (SMILE) implantation was applied in cases with advanced keratoconus. Some authors reported the implantation of SMILE intrastromal lenticules combined with accelerated collagen cross-linking. Others performed intrastromal implantation of negative meniscus-shaped corneal stroma lenticules. Others have compared the outcomes of penetrating keratoplasty (PKP) vs. small-incision Intralase femtosecond (IFS) intracorneal concave lenticule implantation (SFII). Femtosecond laser-assisted small incision sutureless intrasotromal lamellar keratoplasty (SILK) has been also investigated. The published evidence shows that the implantation of autologous ADASCs, decellularized or recellularized human corneal stroma, allogenic SMILE lenticules corneal inlay, and recombinant cross-linked collagen have shown initially to be potentially effective for the treatment of advanced keratoconus. In light of the present evidence available, it can be said that the era of corneal stromal regeneration therapy has been already started. |
| first_indexed | 2024-12-17T06:25:28Z |
| format | Article |
| id | doaj.art-c5d066a09f394f85b3a5eb819198ff76 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-17T06:25:28Z |
| publishDate | 2021-02-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-c5d066a09f394f85b3a5eb819198ff762022-12-21T22:00:18ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-02-01810.3389/fmed.2021.650724650724Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus TreatmentMona El Zarif0Mona El Zarif1Mona El Zarif2Mona El Zarif3Jorge L. Alió4Jorge L. Alió5Jorge L. Alió del Barrio6Jorge L. Alió del Barrio7Maria P. De Miguel8Karim Abdul Jawad9Nehman Makdissy10Optica General, Saida, LebanonDivision of Ophthalmology, Universidad Miguel Hernández, Alicante, SpainFaculty of Sciences, GSBT Genomic Surveillance and Biotherapy Team, Mont Michel Campus, Lebanese University, Beirut, LebanonDoctoral School of Sciences and Technology, Lebanese University, Hadath, LebanonDivision of Ophthalmology, Universidad Miguel Hernández, Alicante, SpainCornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, SpainDivision of Ophthalmology, Universidad Miguel Hernández, Alicante, SpainCornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, SpainCell Engineering Laboratory, IdiPAZ, La Paz Hospital Research Institute, Madrid, SpainOptica General, Saida, LebanonFaculty of Sciences, GSBT Genomic Surveillance and Biotherapy Team, Mont Michel Campus, Lebanese University, Beirut, LebanonThe use of advanced therapies with stem cells to reconstruct the complex tissue of corneal stroma has gained interest in recent years. Besides, collagen-based scaffolds bioengineering has been offered as another alternative over the last decade. The outcomes of the first clinical experience with stem cells therapy on corneal stroma regeneration in patients with advanced keratoconus were recently reported. Patients were distributed into three experimental groups: Group 1 (G-1) patients underwent implantation of autologous adipose-derived adult stem cells (ADASCs) alone, Group 2 (G-2) received a 120 μm decellularized donor corneal stromal laminas, and Group 3 (G-3) received a 120 μm recellularized donor laminas with ADASCs. A follow up of 36 months of clinical data, and 12 months of confocal microscopy study was performed, the authors found significant clinical improvement in almost all studied mean values of primary and secondary outcomes. Corneal confocal microscopy demonstrated an increase in cell density in the host stroma, as well as in the implanted tissue. Using different approaches, allogenic small incision lenticule extraction (SMILE) implantation was applied in cases with advanced keratoconus. Some authors reported the implantation of SMILE intrastromal lenticules combined with accelerated collagen cross-linking. Others performed intrastromal implantation of negative meniscus-shaped corneal stroma lenticules. Others have compared the outcomes of penetrating keratoplasty (PKP) vs. small-incision Intralase femtosecond (IFS) intracorneal concave lenticule implantation (SFII). Femtosecond laser-assisted small incision sutureless intrasotromal lamellar keratoplasty (SILK) has been also investigated. The published evidence shows that the implantation of autologous ADASCs, decellularized or recellularized human corneal stroma, allogenic SMILE lenticules corneal inlay, and recombinant cross-linked collagen have shown initially to be potentially effective for the treatment of advanced keratoconus. In light of the present evidence available, it can be said that the era of corneal stromal regeneration therapy has been already started.https://www.frontiersin.org/articles/10.3389/fmed.2021.650724/fullstem cellsregenerative medicinecorneal bioengineeringcorneal stem cell therapykeratoconusautologous adipose-derived adult stem cells |
| spellingShingle | Mona El Zarif Mona El Zarif Mona El Zarif Mona El Zarif Jorge L. Alió Jorge L. Alió Jorge L. Alió del Barrio Jorge L. Alió del Barrio Maria P. De Miguel Karim Abdul Jawad Nehman Makdissy Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment Frontiers in Medicine stem cells regenerative medicine corneal bioengineering corneal stem cell therapy keratoconus autologous adipose-derived adult stem cells |
| title | Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment |
| title_full | Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment |
| title_fullStr | Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment |
| title_full_unstemmed | Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment |
| title_short | Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment |
| title_sort | corneal stromal regeneration a review of human clinical studies in keratoconus treatment |
| topic | stem cells regenerative medicine corneal bioengineering corneal stem cell therapy keratoconus autologous adipose-derived adult stem cells |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.650724/full |
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