Efficiency of amniotic membrane transplantation in the management of limbal stem cell deficiency

Abstract

Abstract. Objectives. This paper aims to examine the efficacy, safety, and long term outcomes of amniotic membrane transplantation for corneal surface reconstruction, in cases of limbal stem cell deficiency. Material and methods. A systematic literature search was performed on PubMed, for papers published up to February 2020, using the following combined search terms: "limbal stem cell deficiency", "amniotic membrane", "limbal transplant". Only clinical trials with human subjects were selected for analysis. We collected the data on amniotic membrane properties and mechanisms of action, processing, preservation and transplantation techniques, and clinical outcomes of different treatment methods. Results. The surgical approach for treating limbal stem cell deficiency depends on the extent of the disease. Isolated amniotic membrane transplantation appears to have a limited beneficial effect on limbal stem cells, whereas amniotic membrane transplantation, combined with certain types of limbal stem cell transplantation, provides long-term biological and mechanical support for the donor tissue explants. Combined with simple limbal epithelial transplantation, the amniotic membrane has shown excellent results in the surgical management of limbal stem cell deficiency. Conclusions. Preliminary results of amniotic membrane use in limbal transplantation show quite satisfactory data, but the lack of high-level randomized controlled studies makes it difficult to assess the comparative efficacy of amniotic membrane transplantation in limbal stem cell deficiency surgical management.