Abstract
This study investigates a novel short-term treatment for Limbal Stem Cell Deficiency (LSCD) using a limbal stem cell (LSC) sheet bandage. The method utilizes polytetrafluoroethylene (PTFE) membranes to harvest and transplant LSC sheets for corneal surface regeneration. In cases where autologous tissue was not available, limbal biopsies obtained from patients' relatives were cultured to generate LSC sheets, which were subsequently transferred onto PTFE scaffolds using a bottom-up cell transfer technique. Eight patients with treatment-resistant, end-stage LSCD underwent the procedure and examined during a six-months follow-up. Pre-transplantation assessments confirmed the viability and marker expression of the LSCs. Immunocytochemistry and microscopy validated the structural integrity of the LSC sheets on PTFE, and toxicity assays indicated the scaffold's biocompatibility. Post-operative evaluations showed improvements or stabilization in visual acuity, along with a reduction in the use of lubricating eye drops during a 1-month period. No immediate severe complications were observed. Short-term outcomes were promising, showing corneal surface regeneration and improved patient satisfaction and quality of life. However, long-term success varied at the 6- month follow-up. This LSC sheet bandage acted as a cellular bandage, rapidly restoring the corneal surface and facilitating further therapeutic procedures. The technique may serve as a potential interim solution for patients ineligible for conventional corneal transplants. TRIAL REGISTRATION: The study was registered in the Iranian Registry of Clinical Trials (IRCT) on 2020-05-06 (approval number: IRCT20180724040574N1).