ESCRS - PO635 - Regenerative Potential Of Limbal Epithelial Stem Cells For Graft-Host Junction Modulation In Post Penetrating Keratoplasty Corneal Haze

Regenerative Potential Of Limbal Epithelial Stem Cells For Graft-Host Junction Modulation In Post Penetrating Keratoplasty Corneal Haze

Published 2025 - 43rd Congress of the ESCRS

Reference: PO635 | Type: Free paper | DOI: 10.82333/696e-n086

Authors: Grzegorz Labuz* 1 , Agnieszka Zielinska 2 , Ava Niknahad 1 , Zhiyi Wu 3 , Hyeck-Soo Son 4 , Gerd U. Auffarth 1 , Ramin Khoramnia 5

1Department of Ophthalmology,University of Heidelberg,Heidelberg,Germany, 2Department of Ophthalmology,University of Heidelberg,Heidelberg,Germany;Institute of Physics,Nicolaus Copernicus University in Torun,Torun,Poland, 3Department of Ophthalmology,University of Heidelberg,Heidelberg,Germany;Eye Center,The Second Affiliated Hospital, Zhejiang University,Hangzhou,China, 4Department of Ophthalmology,University of Heidelberg,Heidelberg,Poland, 5Department of Ophthalmology,University Hospital Carl Gustav Carus,Dresden,Germany

Purpose

To evaluate the efficacy of microscope-integrated optical coherence tomography guided precisely placed limbal epithelial stem cells for modulating graft-host interface

Evaluate the efficacy of iOCT-guided precisely placed limbal epithelial stem cells for modulating graft-host interface

Setting

Tertiary care centre in Western India

Methods

Prospective interventional pilot study with a sample size of 7 patients with mean age of 46±20.09 years. Collaborative corneal transplantation study group host corneal clarity grade ≤2, presence of superficial punctate keratopathy,epithelial defects at graft host junction,epithelial defects,microcystic edema, ASOCT signs of visible gap ≥50um between host and donor epithelium,difference in epithelial thickness ≥20um were the inclusion criteria(≥3 months post penetrating keratoplasty) and eyes with previous ocular comorbidities ,history of graft rejection/failure were excluded from the study.Selected patients underwent precise placement of limbal stem cells with amniotic membrane. Follow up period for these patients was 3 months. 

Results

Mean change in corneal clarity grade was 2±0.5.Mean BCVA prior to surgery was logMAR 0.72±0.17 and post procedure was logMAR 0.43± 0.14. There was significant improvement at the graft-host interface and regularised the junction.

Conclusions

Graft-host junction irregularities are a major but overlooked challenge post-PK. This is the first study to explore the application of iOCT-guided precisely placed limbal epithelial stem cells for addressing graft-host junction abnormalities and persistent corneal haze after PK.No major complications or adverse events were observed during the study period. However, longer follow-up is required.