TY - JOUR
T1 - Ocular surface reconstruction
T2 - Recent innovations, surgical candidate selection and postoperative management
AU - Nguyen, Pho
AU - Yiu, Samuel C.
N1 - Funding Information:
Samuel Yiu, PhD, MD, has a patent application pending for the artificial lacrimal gland. Pho Nguyen, MD, declares that there is no conflict of interest. The Bioartificial Lacrimal Gland Study by Yiu and colleagues was supported by National Eye Institute Grants EY-03040, EY-15457 and a Baxter Foundation Junior Faculty Award to Yiu. It was also supported by an unrestricted grant from Research to Prevent Blindness. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscripts apart from those disclosed.
PY - 2008
Y1 - 2008
N2 - Intricate homeostasis maintains the rich complexity and functionality of the ocular surface. Severe ocular surface diseases cause significant morbidities, including blindness. Ocular surface reconstruction strategies restore this homeostasis. Patients with limbal deficiency may benefit from limbal stem cell transplantation to alleviate persistent epithelial defects, maintain conjunctivalization regression and corneal avascularity, and restore vision. Amniotic membrane and other substrates function as tissue surrogates and substrates for expansion of stem cells. Maximum graft survivability necessitates aggressive and comprehensive preoperative management of inflammation, infection, microtrauma, dry eye conditions and HLA compatibility. Restoration of lacrimal gland function is important, as is implementation of aggressive immunosuppression. Future advancements in stem cell biology, tissue engineering, bioartificial microsystems or regenerative medicine will supplement the therapeutic armamentarium. The next decade will be an exciting time for corneal surgeons.
AB - Intricate homeostasis maintains the rich complexity and functionality of the ocular surface. Severe ocular surface diseases cause significant morbidities, including blindness. Ocular surface reconstruction strategies restore this homeostasis. Patients with limbal deficiency may benefit from limbal stem cell transplantation to alleviate persistent epithelial defects, maintain conjunctivalization regression and corneal avascularity, and restore vision. Amniotic membrane and other substrates function as tissue surrogates and substrates for expansion of stem cells. Maximum graft survivability necessitates aggressive and comprehensive preoperative management of inflammation, infection, microtrauma, dry eye conditions and HLA compatibility. Restoration of lacrimal gland function is important, as is implementation of aggressive immunosuppression. Future advancements in stem cell biology, tissue engineering, bioartificial microsystems or regenerative medicine will supplement the therapeutic armamentarium. The next decade will be an exciting time for corneal surgeons.
KW - Amniotic membrane
KW - Limbal stem cell transplant
KW - Ocular surface reconstruction
KW - Patient management
KW - Prosthesis
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U2 - 10.1586/17469899.3.5.567
DO - 10.1586/17469899.3.5.567
M3 - Review article
AN - SCOPUS:69949173164
SN - 1746-9899
VL - 3
SP - 567
EP - 584
JO - Expert Review of Ophthalmology
JF - Expert Review of Ophthalmology
IS - 5
ER -