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Am J Ophthalmol Case Rep. 2019 Jul 30;15:100532. doi: 10.1016/j.ajoc.2019.100532. eCollection 2019 Sep.

Grafting of an autologous tissue-engineered human corneal epithelium to a patient with limbal stem cell deficiency (LSCD).

Le-Bel G1,2,3,4, Guérin LP1,2,3, Carrier P1,2,4, Mouriaux F1,2,3,5,6, Germain L1,2,3,4, Guérin SL1,2,3, Bazin R1,2,3.

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CUO-Recherche, Médecine Régénératrice, Centre de recherche du CHU de Québec, Université Laval, Québec, Canada.
Centre de Recherche en Organogénèse expérimentale de l'Université Laval/LOEX, Québec, Canada.
Département d'Ophtalmologie, Faculté de médecine, Université Laval, Québec, QC, Canada.
Département de Chirurgie, Faculté de médecine, Université Laval, Québec, QC, Canada.
CNRS, UMR 6301 ISTCT, CERVOxy, GIP CYCERON, F-14074, Caen, France.
CHU de Rennes, Service d'Ophtalmologie, F-35033, Cedex 9, France.



In this study, we evaluated the feasibility of recovering the corneal surface integrity in a patient suffering from unilateral LSCD through the transplantation of cultured autologous corneal epithelial cells.


Human corneal epithelial cells (HCECs) were isolated from a limbal biopsy of the contralateral eye of a patient with unilateral LSCD and cultured in monolayer in the presence of an irradiated human fibroblasts feeder layer (iHFL). To produce a cultured autologous corneal epithelium (CACE), HCECs were seeded on a fibrin substrate and maintained in culture until confluence. The in vitro obtained CACE was then used to treat the affected eye of the patient. Two years later, a successful penetrating keratoplasty was performed.


Efficient restoration of the corneal epithelium was achieved following transplantation of CACE indicating probable re-colonization of the cornea by stem cells. Corneal transparency was restored after removing the scarred stroma by performing a penetrating keratoplasty.


CACE produced in vitro was shown to restore a normal corneal surface capable of sustaining a viable and clear penetrating keratoplasty and reestablished a near normal vision in a unilateral LSCD patient.


Autologous graft; Cornea; Limbal stem cell deficiency; Penetrating keratoplasty; Tissue engineering

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