Research Article: Subconjunctival Injection of Mesenchymal Stem Cells for Corneal Wound Healing After Chemical Injury: Impact on Epithelial Coverage, Limbal Ischemia, and Ocular Surface Inflammatory
Abstract:
Previous studies in animal models have demonstrated that mesenchymal stem cells (MSCs) are beneficial for reconstructing the ocular surface during corneal wound healing; however, clinical evidence remains scarce. This study aimed to evaluate the clinical safety, feasibility, and preliminary outcomes of subconjunctival umbilical-cord delivered-MSC (UC-MSC) injection as an adjunctive therapy for severe corneal chemical injuries.
This prospective, single-arm clinical case series enrolled six patients with severe corneal chemical injuries. Human UC-MSCs at passages 5–6 were cultured and verified. A total sample of 4?×?10 6 cells suspended in 400??L of 1?×?Hanks’ Balanced Salt Solution (HBSS) were subconjunctivally delivered adjacent to the limbus using a 360° circumferential injection technique. Concurrently, all patients underwent amniotic membrane transplantation (AMT) and received a standard 4-week topical regimen (Tobradex, recombinant human epidermal growth factor, and Solcoseryl). Clinical safety, limbal ischemia, inflammatory indices, and epithelial defect areas were assessed through a digital slit-lamp examination.
No localized or systemic adverse events, such as anterior uveitis, progressive ulceration, intraocular infection, or immunological rejection, were observed in any participant. By 4?weeks post-injection, active ocular surface inflammation had significantly decreased in all eyes. Of the five patients with baseline limbal ischemia, four achieved complete revascularization and resolution; the fifth exhibited a marked reduction in ischemia from 100 to 20%. Furthermore, stable corneal re-epithelialization was achieved in five of six eyes, including one with complete paracentral epithelial coverage.
Subconjunctival UC-MSC delivery is a safe and feasible adjunctive therapy for managing severe corneal chemical injuries. This cell-based intervention synergizes with conventional therapies to suppress acute inflammation, rescue limbal perfusion while potentially mitigating subsequent corneal neovascularization, and accelerate the structural reconstruction of the ocular surface microenvironment.
Introduction:
The ocular surface microenvironment (OSM) comprises tissue components, including the cornea, conjunctiva, meibomian glands, lacrimal glands, and the neural network; specific cells, including immune and matrix cells; the extracellular matrix; small molecules; and the microbiome ( 1–3 ). In a healthy, non-senescent ocular surface microenvironment, these components function harmoniously to maintain ocular surface homeostasis, corneal transparency, and normal ocular function ( 4–6 ). Disruption of the OSM by chemical…
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