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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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Autores principales: El Zarif, Mona, Alió, Jorge L., Alió del Barrio, Jorge L., De Miguel, Maria P., Abdul Jawad, Karim, Makdissy, Nehman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940685/
https://www.ncbi.nlm.nih.gov/pubmed/33708786
http://dx.doi.org/10.3389/fmed.2021.650724
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author El Zarif, Mona
Alió, Jorge L.
Alió del Barrio, Jorge L.
De Miguel, Maria P.
Abdul Jawad, Karim
Makdissy, Nehman
author_facet El Zarif, Mona
Alió, Jorge L.
Alió del Barrio, Jorge L.
De Miguel, Maria P.
Abdul Jawad, Karim
Makdissy, Nehman
author_sort El Zarif, Mona
collection PubMed
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.
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spelling pubmed-79406852021-03-10 Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment El Zarif, Mona Alió, Jorge L. Alió del Barrio, Jorge L. De Miguel, Maria P. Abdul Jawad, Karim Makdissy, Nehman Front Med (Lausanne) Medicine 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. Frontiers Media S.A. 2021-02-23 /pmc/articles/PMC7940685/ /pubmed/33708786 http://dx.doi.org/10.3389/fmed.2021.650724 Text en Copyright © 2021 El Zarif, Alió, Alió del Barrio, De Miguel, Abdul Jawad and Makdissy. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
El Zarif, Mona
Alió, Jorge L.
Alió del Barrio, Jorge L.
De Miguel, Maria P.
Abdul Jawad, Karim
Makdissy, Nehman
Corneal Stromal Regeneration: A Review of Human Clinical Studies in Keratoconus Treatment
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 Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940685/
https://www.ncbi.nlm.nih.gov/pubmed/33708786
http://dx.doi.org/10.3389/fmed.2021.650724
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