Limbal Stem Cell Deficiency: Diagnostic Criteria and Transplantation Outcomes
DOI:
https://doi.org/10.5281/zenodo.22274407Keywords:
Limbal stem cell deficiency; Corneal epithelium; Limbal transplantation; Diagnostic staging; Graft potencyAbstract
Background: Limbal stem cell deficiency destroys the corneal epithelial progenitor population. A 2019 global consensus fixed
staging by the central 5 mm zone and the arc of limbal involvement, but postdates almost every outcome series.
Objective: To set out the diagnostic criteria as they now stand and ask what the comparative transplantation outcome
literature can legitimately support.
Methods: Narrative review of cytology and imaging studies, consensus statements, surgical cohorts, meta-analyses and one
phase I/II trial.
Findings: Reported success ranges from 64.7% to 83.8% across techniques whose endpoints and follow-up differ. Cultivated
autologous grafts restored the epithelium permanently in 76.6% of eyes in a 112-patient series; within it, grafts with more
than 3% p63-bright cells succeeded in 78% of patients against 11% where p63-bright cells were 3% or less.
Conclusions: The evidence supports staged diagnosis and graft potency as a predictor of outcome, but not ranking surgical
techniques by their headline success rates.
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