title: Limbal Stem Cell Deficiency: Current Treatment Options and Emerging Therapies.
abstract: Severe ocular surface disease can result in limbal stem cell deficiency (LSCD), a condition leading to decreased visual acuity, photophobia, and ocular pain. To restore the ocular surface in advanced stem cell deficient corneas, an autologous or allogenic limbal stem cell transplantation is performed. In recent years, the risk of secondary LSCD due to removal of large limbal grafts has been significantly reduced by the optimization of cultivated limbal epithelial transplantation (CLET). Despite the great successes of CLET, there still is room for improvement as overall success rate is 70% and visual acuity often remains suboptimal after successful transplantation. Simple limbal epithelial transplantation reports higher success rates but has not been performed in as many patients yet. This review focuses on limbal epithelial stem cells and the pathophysiology of LSCD. State-of-the-art therapeutic management of LSCD is described, and new and evolving techniques in ocular surface regeneration are being discussed, in particular, advantages and disadvantages of alternative cell scaffolds and cell sources for cell based ocular surface reconstruction.
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Campus Drie Eiken, T building, T4-Ophthalmology, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Dienst Oogheelkunde, Wilrijkstraat 10, 2650 Edegem, Belgium; Research Foundation-Flanders, Egmontstraat 5, 1000 Brussels, Belgium.
authors.forename: Michel
authors.initials: M
authors.lastname: Haagdorens
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Campus Drie Eiken, T building, T4-Ophthalmology, Universiteitsplein 1, 2610 Antwerp, Belgium.
authors.forename: Sara Ilse
authors.initials: SI
authors.lastname: Van Acker
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Campus Drie Eiken, T building, T4-Ophthalmology, Universiteitsplein 1, 2610 Antwerp, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: Van Gerwen
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Campus Drie Eiken, T building, T4-Ophthalmology, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Dienst Oogheelkunde, Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Sorcha
authors.initials: S
authors.lastname: Ní Dhubhghaill
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Campus Drie Eiken, T building, T4-Ophthalmology, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Dienst Oogheelkunde, Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Carina
authors.initials: C
authors.lastname: Koppen
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Campus Drie Eiken, T building, T4-Ophthalmology, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Dienst Oogheelkunde, Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: Tassignon
authors.affiliation: Faculty of Medicine and Health Sciences, Department of Ophthalmology, Visual Optics and Visual Rehabilitation, University of Antwerp, Campus Drie Eiken, T building, T4-Ophthalmology, Universiteitsplein 1, 2610 Antwerp, Belgium; Department of Ophthalmology, Antwerp University Hospital, Dienst Oogheelkunde, Wilrijkstraat 10, 2650 Edegem, Belgium; Center for Cell Therapy and Regenerative Medicine, Antwerp University Hospital, CCRG-Oogheelkunde, Wilrijkstraat 10, 2650 Edegem, Belgium.
authors.forename: Nadia
authors.initials: N
authors.lastname: Zakaria