Eyeworld

71 EW INTERNATIONAL July 2017 Editors' note: Dr. Basu has no financial interests related to his comments. Contact information Basu: sayanbasu@lvpei.org They anticipate rapid corneal heal- ing. The clinical outcomes in these patients are pending. EW MSCs can also be used in the acute inflammatory stage, without the application of topical or systemic steroids, which are normally used intensively in burn or ulcer patients. the collagen fibers. In the control group we did the same thing but ap- plied gel without MSCs, and we saw that the differences were clinically and visually significant." The no-bank alternative In India, 1.8 million people have corneal blindness, of which 30% are children, and which accounts for 14% of all cases of blindness. Fifty-five percent of corneal blind- ness results from infection and scars, which is 30% from endothelial dis- ease and 11% from keratoconus and dystrophies. Each year, the number of people with corneal blindness increases by 30,000. More than 50% of the indica- tions for transplants in India have a fair to poor prognosis, largely due to the fact that corneal transplants do not do well in eyes that have had inflammation, that are likely to have inflammation, or that are vascu- larized. In addition, the budding network of corneal banks in India has a deficient corneal collection of 30,000 per year along with an inade- quate number of corneal specialists. "Early on, MSCs were only known to exist in bone marrow, but we now know that stem cells can be found in adipose tissue, dental pulp, and corneal stroma as well, just below where the limbal epithelial stem cells are located," Dr. Basu said. "They are an important component of the niche. Our idea, initially, was to have a tissue source with less risk of rejection and not have to depend on donor tissue as much because in the developing world there is an extreme scarcity of corneal tissue. We also thought we should have a system of delivery that is simple and does not require a complicated procedure, which in this case is a 5-minute procedure under topical anesthesia. Also, one vital aspect of this whole procedure is the fact that in diseases involving corneal opac- ities and scars, the limbus is not al- ways affected. In the most common forms of corneal stromal diseases, the limbus is actually spared. And if one eye is affected, you always have the other eye that you can harvest the MSCs from." Drs. Basu and Singh are using both autologous and allogeneic lim- bal-derived MSCs in patients with corneal scars, ulcers, and burns. The

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