Purpose: To identify the position and magnitude of lens compression due to short-term miniscleral contact lens wear, as well as evaluating the usefulness of scleral asymmetry as a predictor for scleral lens decentered compression. Methods: Fourteen healthy subjects (mean AE S.D.: 29.2 AE 6.0 years) wore a highly gas-permeable spherical haptic miniscleral contact lens during a 5-h period. Corneo-scleral height Fourier profilometry was captured using an Eye Surface Profiler (www.eaglet-eye.com) before and immediately after lens removal. Scleral asymmetry, lens compression location and magnitude were processed using custom-made algorithms, both globally and for scleral quadrants. Results: Miniscleral contact lenses do not set uniformly on the ocular surface, with the largest decentration seen along the horizontal meridian. The greatest flexural stress exerted by the lens on the ocular surface occurs at the point coinciding with the inner diameter landing point of the lens and not with its overall diameter. Scleral asymmetry was significantly correlated with compression location (R = 0.71, p = 0.002) and compression magnitude (R = 0.81, p < 0.001), showing its potential as compression predictor. Conclusion: Larger amounts of scleral asymmetry will lead to more decentration of spherical haptic scleral lenses. Objective and accurate methods, like the one presented here, could help the practitioner prevent cases of scleral blanching or discomfort due to an excessive compression by the lens.

Short-term miniscleral contact lens wear in healthy eyes does not produce significant corneal shape changes measured with profilometry but alters sclero-conjuctival topography. In addition, sclero-conjuctival flattening was not uniformly distributed across the anterior eye.

Ex vivo cultivated limbal stem cell transplantation is a promising technique for the treatment of limbal stem cell deficiency. While the results of the clinical trials have been extensively reported since the introduction of the technique in 1997, little has been reported regarding the potential health risks associated with production processes and transplantation techniques. Culture procedures require the use of animal and/or human-derived products, which carry the potential of introducing toxic or infectious agents through contamination with known or unknown additives. Protocols vary widely, and the risks depend on the local institutional methods. Good manufacturing practice and xeno-free culture protocols could reduce potential health risks but are not yet a common practice worldwide. In this review, we focus on the safety of both autologous- and allogeneic-cultivated limbal stem cell transplantation, with respect to culture processes, surgical approaches, and postoperative strategies.

Purpose: To evaluate the short- and long-term success rates of xenogeneic-free cultivated limbal epithelial stem cell transplantation (CLET) for the treatment of limbal stem cell deficiency (LSCD). Methods: Thirteen patients with LSCD underwent an autologous (n = 9) or allogeneic (n = 4) CLET. The primary end point was to assess the long-term anatomical success rate of transplanted grafts at a follow-up of at least 3 years, in comparison with the short-term outcomes. Secondary end points involved reviewing functional improvement, patient-reported symptoms, and change in percentage area of corneal vascularization in both short-term and long-term. Results: The mean short- and long-term follow-up periods were 2.1 ± 0.38 years and 6.7 ± 1.81 years, respectively. The total anatomical success rate was 46.1% in the short-term, but it decreased to 23.1% in the long-term. A partial success rate of 30.8% was observed in both short- and long-term, and the failure rate increased from 23.1% to 46.1%. The mean percentage of vessel area decreased from 12.11% ± 5.29% preoperatively to 7.82% ± 6.70% in the short-term and increased to 8.70% ± 6.32% in the long-term. There was a significant improvement in best-corrected visual acuity (P = 0.044) in the short-term although not in the long-term (P = 0.865). Conclusions: This study shows that anatomical and functional success rates of CLET decrease over time. We believe that the decline of success is related to the extent of disease, cell origin, and lack of niche protection because subtotal LSCD and autologous donor cells confer a higher chance of success in the long-term.