Stem cell transplantation may improve long-term corneal graft survival

NICE, France — Transplantation of corneal epithelial stem cells may help increase corneal graft survival in patients who previously had little hope of success, according to a surgeon here.

Ulf Stenevi, MD, PhD, said the prognosis for keratoplasty in patients with severe chemical burns is poor, with the grafts generally not surviving. However, in his retrospective review of six patients treated with a graft technique, patients had good results after 3 years. He reported his results at the European Society of Cataract and Refractive Surgery annual meeting.

According to Dr. Stenevi, five of the six patients accepted the donor cells. Although the one case of rejection was in a severely traumatized eye, Dr. Stenevi is not certain why the sixth patient failed.

Dr. Stenevi said the study also proved that transplanted stem cells do survive on the eyes.

In the study, some of the donor corneal epithelial cells were taken from a patient of the opposite sex from the recipient. The researchers then used a technique that stained the X and Y chromosomes of the transplanted stem cells differently. Sampling of the corneal cells after 3 years then indicated whether the transplanted cells survived.

“Let’s assume the donor is female and the patient is male,” Dr. Stenevi said. “If you can sample the epithelial cells 3 years after transplantation and show that there are female chromosomes, then that shows the cells survived transplantation. If they were all male origin, then all those cells are from the patient.”

Investigators were not initially concerned about the sex of the patient and whether stem cells from a different-sex donor would be accepted.

“Nobody thinks it makes any difference if you have same sex or different sex. The conclusion of the study was that although most patients are clinically successful, it is not a simple correlation that we can show surviving cells from the stem cells in long-term patients.” he said.

For more on Dr. Stenevi’s technique, see the Jan. 1 print edition of Ocular Surgery News.