Italy – The Cornea Heals Itself with Stem Cells

Limbus stem cell transplants (a layer of adult stem cells surrounding the cornea responsible for restoring corneal epithelium naturally during life) rebuild the ocular surface when damaged due to chemical and physical agents (like lime). They also repair “injuries” due to improper use of contact lenses. Vincenzo Sarnicola, a cornea and stem cell transplant expert, leading ocular surface specialist in Grosseto, Professor of Ocular Surface Surgery at the University of Siena, and President of the Italian Stem Cell and Ocular Surface Society (SICSSO) explained, “When the ocular surface loses its stem cells it is unable to defend itself and make repairs, it then loses transparency and develops soars, which become infected and result in anatomical loss. Restoring the deficient surface with limbus stem cell transplants means giving hope to these eyes and to those patients who are in serious condition often due to work related accidents.

The patient’s stem cells can be removed, cultivated, and reapplied where necessary in the cornea”. Cornea transplants are also increasingly widespread with over 6 thousand performed each year in Italy, and 400 thousand performed in the United States. The first operation of this kind was performed by von Hipple in 1875 when he transplanted a rabbit’s cornea into a human being. Sarnicola said proudly, “Tuscany is the top region in Europe for cornea transplants per million inhabitants”. Sarnicola’s medical team contributed to designing a new technique called Deep Anterior Lamellar Keratoplasty (DALK), developed in Japan.

“The DALK method executes cornea transplants by removing only the surface and stroma without touching the internal endothelial tissue, a very thin membrane, which when transplanted, is the main cause of rejection. Cornea transplants have been revolutionized and today only a few microns of damaged cornea are removed in the procedure while the entire cornea is 12mm long and 600 microns thick. We have improved results and reduced possible complications both during and after operations”. In a perforated cornea transplant, rejection occurs in only 10% of the cases, and it is possible to treat 80% of these cases with therapy. Sarnicola concluded, “DALK allows untreatable rejections to be eliminated”.

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