Study Finds Stem Cells Can Improve Corneal Wound Healing

Corneal Wound HealingAs the anterior-most structure of the eye, the cornea plays an important role in vision and is prone to potential injuries, infections and other disease conditions. Recent research conducted by the team at Cedars Sinai Medical Center has found that by using corneal stem cells, corneal injuries from burns, abrasions, contact lens problems, insufficient tear production, infections and other conditions can be treated. Corneal wound healing is a complex process and incomplete or delayed healing is a major concern for clinicians, as it creates serious complications. While most corneal wounds heal without permanent visual impairment and do not require hospitalization, only a few can have a longer term impact on the patient’s quality of life. Though usually self-limiting, wounds in the cornea are common and a major reason for visits to hospital emergency departments.

Injuries to the outer surface of the eye may be due to abrasions, chemical injuries, contact lens problems, foreign bodies, or ultraviolet injuries. The cornea has three main types of cells – the stratified surface epithelium, the stromal keratocytes, and the innermost single-layered endothelial cells. All have similarities and differences in the way they heal wounds. The healing process is documented at clinics using a woundcare EHR.

Corneal wound healing involves diverse phases:

  • Latent phase 4-6 hours
  • Cell migration and adhesion 24 – 36 hours
  • Cell proliferation lasts 36 hours to several months

The study published in the July edition of Stem Cells found that stem cells are vital in corneal epithelial, stromal, and endothelial wound healing in disease, injury and postsurgical corneal wound healing.

“The advances in transplant techniques and the range of available cell sources that can be used to optimize the treatment of aberrant corneal wound healing can give reassurance to patients with corneal injuries that preserving vision may be possible in the near future,” wrote the researchers in the study.

It was found that clinical success in normal healing restoration has been achieved mainly for epithelial cells with the advent of cultured LESC transplantation for LSCD caused by various burns. This technique has proven to be as efficient as the previously introduced biopsy-based keratolimbal transplantation.

Eye trauma should always be fully assessed and documented, as penetrating injuries are otherwise easily missed and can rapidly lead to sight-threatening infections. Advanced wound care software programs allow faster and safer documentation. Documented history of the wounds should also include time elapsed since injury, circumstances of injury, mode of injury, other injuries sustained, current symptoms, past medical history, and medications and allergies. For conditions related to the cornea, it is recommended to perform a Seidel’s test first and then assess for corneal abrasion with dilute fluorescein.