Limbal stem cell
adult somatic stem cell found in the basal epithelial layer of the limbus corneae
Limbal stem cells, also known as corneal epithelial stem cells, are unipotent stem cells located in the basal epithelial layer of the corneal limbus. They form the border between the cornea and the sclera. Characteristics of limbal stem cells include a slow turnover rate, high proliferative potential, clonogenicity, expression of stem cell markers, as well as the ability to regenerate the entire corneal epithelium. Limbal stem cell proliferation has the role of maintaining the cornea; for example, by replacing cells that are lost via tears. Additionally, these cells also prevent the conjunctival epithelial cells from migrating onto the surface of the cornea.
Medical conditions and treatments
Damage to the limbus can lead to limbal stem cell deficiency (LSCD); this may be primary - related to an insufficient stromal microenvironment to support stem cell functions, such as aniridia, and other congenital conditions, or secondary – caused by external factors that destroy the limbal stem cells, such as chemical or thermal burns, radiation, surgery, infection, use of contact lenses, or certain drugs.
Signs and symptoms include: conjunctivalisation, corneal vascularisation, ocular discomfort or pain, visual impairment, photophobia, and blindness, which are likely associated with failure in the process of regenerating the corneal epithelium.
Immediate management aims to limit traumatic or chemical damage to the limbus, control inflammation, and help achieve a healthy corneal epithelium. Initial treatment after trauma/injury includes preservative-free artificial tears, topical steroids, 'bandage' contact lenses, and autologous eye drops (eye drops manufactured from the patient's own blood serum and plasma). Once the corneal surface has stabilized, surgery is the main approach to treatment.
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