ORCID
0000-0002-6415-3888 (Ramanathan)
Document Type
Article
Publication Date
2026
DOI
10.3389/fopht.2026.1836045
Publication Title
Frontiers in Ophthalmology
Volume
6
Pages
1836045
Abstract
Allogeneic ocular surface stem cell transplantation (OSST) is an established therapeutic approach for limbal stem cell deficiency, utilizing techniques such as keratolimbal allograft (KLAL), living-related conjunctival limbal allograft (lr-CLAL), allogeneic cultivated limbal epithelial transplantation (allo-CLET), and allogeneic simple limbal epithelial transplantation (allo-SLET). This review synthesizes evidence from 35 studies encompassing 1, 268 eyes with at least 24 months of follow-up to evaluate intermediate- and long-term outcomes. Overall, OSST is associated with improvement in visual acuity and restoration of ocular surface stability, although success rates vary widely by technique, ranging from 13% to 87%. Outcomes appear to be influenced by the intensity of systemic immunosuppression, with triple-agent regimens demonstrating higher rates of long-term success compared with single- or dual-agent approaches. Among techniques, lr-CLAL may offer advantages over KLAL due to lower rejection rates. Despite encouraging results, long-term data remain limited for newer approaches such as allo-CLET and allo-SLET. Careful postoperative monitoring and management of complications, including rejection, glaucoma, and microbial keratitis, remain essential to optimize outcomes.
Rights
© 2026 Cheung, Quiroz-Casian, Sarnicola, Ramanathan, Nath and Holland.
This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Original Publication Citation
Cheung, A., Quiroz-Casian, N., Sarnicola, E., Ramanathan, G. C., Nath, S., & Holland, E. J. (2026). Outcomes of allogeneic ocular surface stem cell transplantation. Frontiers in Ophthalmology, 6, Article 1836045. https://doi.org/10.3389/fopht.2026.1836045
Repository Citation
Cheung, A., Quiroz-Casian, N., Sarnicola, E., Ramanathan, G. C., Nath, S., & Holland, E. J. (2026). Outcomes of allogeneic ocular surface stem cell transplantation. Frontiers in Ophthalmology, 6, Article 1836045. https://doi.org/10.3389/fopht.2026.1836045
Supplementary Table 1
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Supplementary Table 2
table 3.docx (16 kB)
Supplementary Table 3
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Supplementary Table 4