Sutureless ocular surface reconstruction

Corneal diseases account for eight million blind people worldwide, making up to 10% of all causes of blindness. As 80% of the information is collected by our senses, blindness is a very invalidating condition which lowers greatly patients’ quality of life. Limbal stem cell deficiency describes all the conditions involving the failure of corneal epithelium and its progressive replacement by conjunctival epithelium and the opacification of the cornea, creating ultimately a loss of vision. Restoring transparency by reconstructing the ocular surface with a healthy corneal epithelium is the only long term treatment of this condition and has been a major challenge for regenerative medicine for the past twenty years. As the understanding of corneal epithelium renewal increases, the solutions offered to restore visual acuity are improving but the long term results of techniques used so far are still poor. We describe here an attempt to fix the issue of inflammation due to sutures in the case of transplantation of limbal epithelial cells carried by an amniotic membrane, by the use of an adhesive. LYDEX, our chemically defined bioadhesive uses food additives as building blocks for the formation of an hydrogel, which has been described to be perfectly bio-compatible. Results of this study confirm the absence of immunological reaction in the presence of our hydrogel but also bring to light its potentially insufficient permeability to glucose, which combined to mechanical trauma, leads to a dramatic failure of the grafted epithelium