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Title

Outcomes of allogenic cultivated limbal epithelial stem cells in aniridia patients

Purpose	To assess the results of transplanting allogenic cultivated limbal epithelial stem cell grafts in aniridia patients suffering from severe limbal stem cell deficiency.
Methods	Between January 2010 and March 2017 six aniridia patients with severe limbal stem cell deficiency received an allogenic cultivated limbal stem cell graft at the Antwerp University Hospital. The limbo-amnion grafts were generated by cultivating limbal epithelial stem cells from HLA-matched living related (n=5) or cadaveric (n=1) donor eyes on a standardized amniotic membrane. Post-operative corneal surface stability, visual outcomes and complications were assessed. Anatomical outcome was graded as ‘total success’, ‘partial success’ or ‘failure’.
Results	One patient was excluded because of loss to follow-up. The mean follow-up of the remaining patients was 47,8 months (range 11 – 104 months). In all of the patients there was an improvement in clinical signs early post-operatively, which slowly regressed during the follow-up course. At the final follow-up, two patients were graded as partial success and three patients were graded as failure. None of the patients experienced a total anatomical success. In only one of the patients there was a modest improvement in BCVA from hand movements to counting fingers. One of the eyes was complicated by acorneal ulcer 16 months post-operatively.
Conclusion	Severe limbal stem cell deficiency in aniridia remains a challenging condition to manage. Transplantation of allogenic ex vivo cultivated limbal stem cells in aniridia patients may provide a temporarily improvement in ocular surface stability, but the anatomical and functional results are poor on the long-term.
Conflict of interest	No

Authors 1

Last name	BEHAEGEL
Initials	JB
Department	UZA
City	Edegem

Authors 2

Last name	Carina Koppen
Initials	CK
Department	UZA
City	Edegem

Authors 3

Last name	Nadia Zakaria
Initials	NZ
Department	UZA
City	Edegem

Authors 4

Last name	Tassignon
Initials	MJT
Department	UZA
City	Edegem

Authors 5

Last name	Sorcha Ní Dhubhghaill
Initials	SND
Department	UZA
City	Edegem