EFFICIENCY OF AMNIOTIC MEMBRANE TRANSPLANTATION IN THE MANAGEMENT OF LIMBAL STEM CELL DEFICIENCY

Vitalie Procopciuc; Viorica Mihaluța; Olga Ignatov; Valeriu Cușnir; Viorel Nacu

doi:10.5281/zenodo.4070120

Authors

Vitalie Procopciuc State University of Medicine and Pharmacy “Nicolae Testemiţanu”, Chișinău, Republic of Moldova https://orcid.org/0000-0001-7355-183X
Viorica Mihaluța State University of Medicine and Pharmacy “Nicolae Testemiţanu”, Chișinău, Republic of Moldova
Olga Ignatov State University of Medicine and Pharmacy “Nicolae Testemiţanu”, Chișinău, Republic of Moldova
Valeriu Cușnir State University of Medicine and Pharmacy “Nicolae Testemiţanu”, Chișinău, Republic of Moldova
Viorel Nacu Laboratory of Tissue Engineering and Cell Cultures, Chișinău, Republic of Moldova

DOI:

https://doi.org/10.5281/zenodo.4070120

Keywords:

amniotic membrane, cornea, limbal stem cell deficiency, limbal graft

Abstract

Objectives: This paper aims to examine the efficacy, safety, and long term outcomes of amniotic membrane transplantation for corneal surface reconstruction, in cases of limbal stem cell deficiency.

Material and methods: A systematic literature search was performed on PubMed, for papers published up to February 2020, using the following combined search terms: "limbal stem cell deficiency", "amniotic membrane", "limbal transplant". Only clinical trials with human subjects were selected for analysis. We collected the data on amniotic membrane properties and mechanisms of action, processing, preservation and transplantation techniques, and clinical outcomes of different treatment methods.

Results: The surgical approach for treating limbal stem cell deficiency depends on the extent of the disease. Isolated amniotic membrane transplantation appears to have a limited beneficial effect on limbal stem cells, whereas amniotic membrane transplantation, combined with certain types of limbal stem cell transplantation, provides long-term biological and mechanical support for the donor tissue explants. Combined with simple limbal epithelial transplantation, the amniotic membrane has shown excellent results in the surgical management of limbal stem cell deficiency.

Conclusions: Preliminary results of amniotic membrane use in limbal transplantation show quite satisfactory data, but the lack of high-level randomized controlled studies makes it difficult to assess the comparative efficacy of amniotic membrane transplantation in limbal stem cell deficiency surgical management.