Background: Limbal stem cells (LSCs) are essential for maintaining corneal transparency and ocular surface integrity. Many external factors or genetic diseases can lead to corneal limbal stem cell deficiency (LSCD), resulting in the loss of barrier and corneal epithelial cell renewal functions. Stem cell transplantation is one of the primary treatments for LSCD, including limbal transplantation and cultivated limbal epithelial transplantation. In addition, a variety of non-limbal stem cell lines have been experimented with for LSCD treatment. Biological scaffolds are also used to support in vitro stem cell culture and transplantation. Here, we review the mechanisms of corneal maintenance by LSCs, the clinical stage and surgical treatment of LSCD, the source of stem cells, and the biological scaffolds required for in vitro culture. Methods: This study is a narrative retrospective study aimed at collecting available information on various aspects of surgical treatments for LSCD. Relevant literature was searched in a range of online databases, including Web of Science, Scopus, and PubMed from 2005 to March, 2023. Results: A total of 397 relevant articles were found, and 49 articles with strong relevance to the studies in this paper were obtained and analyzed. Moreover, 11 of these articles were on the concept of LSCD and the mechanism of LESCs maintaining the corneal epithelium, 3 articles on the staging and grading of LSCD, 17 articles on cell transplantation methods and donor cell sources, and 18 articles on scaffolds for delivering stem cells. We also summarized the advantages and disadvantages of different cell transplantation methods and the benefits and limitations of scaffolds based on the above literature. Conclusion: The treatment of LSCD is determined by the clinical stage and whether it involves monocular or binocular eyes. Appropriate surgical techniques should be taken for LSCD patients in order to reconstruct the ocular surface, relieve symptoms, and restore visual function. Meanwhile, biological scaffolds assist in the ex vivo culture and implantation of stem cells.

中文翻译：

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角膜缘干细胞缺乏症的细胞移植治疗进展

背景：角膜缘干细胞（LSC）对于维持角膜透明度和眼表完整性至关重要。许多外界因素或遗传疾病可导致角膜缘干细胞缺乏症（LSCD），导致角膜上皮细胞屏障和更新功能丧失。干细胞移植是LSCD的主要治疗方法之一，包括角膜缘移植和培养角膜缘上皮移植。此外，多种非角膜缘干细胞系已被用于 LSCD 治疗的实验。生物支架也用于支持体外干细胞培养和移植。在此，我们综述LSCs维持角膜的机制、LSCD的临床分期和手术治疗、干细胞的来源以及体外培养所需的生物支架。方法：本研究是一项叙述性回顾性研究，旨在收集有关 LSCD 手术治疗各个方面的可用信息。2005年至2023年3月在Web of Science、Scopus和PubMed等一系列在线数据库中检索相关文献。结果：共找到相关文章397篇，其中与本文研究强相关的文章49篇得到并分析。此外，其中11篇文章涉及LSCD的概念和LESC维持角膜上皮的机制，3篇文章涉及LSCD的分期和分级，17篇文章涉及细胞移植方法和供体细胞来源，18篇文章涉及输送支架干细胞。我们还根据上述文献总结了不同细胞移植方法的优缺点以及支架的优点和局限性。结论：LSCD的治疗取决于临床分期以及是否涉及单眼或双眼。LSCD患者应采取适当的手术技术，以重建眼表、缓解症状、恢复视功能。同时，生物支架有助于干细胞的离体培养和植入。