Ready, Steady, Graft

The first cultivated autologous limbal epithelial cell transplantation (CALEC) has been performed in the US. The technique, developed in 2018 by researchers at Harvard Medical School (HMS), Massachusetts Eye and Ear, Boston Children’s Hospital, and Dana-Farber Cancer Institute, was used to treat four patients with chemically induced corneal injuries. CALEC uses a patient’s limbal stem cells – found at the outer border of the cornea – to create an ocular graft. The cells are processed in a clean room environment to maintain maximum sterility over a period of approximately three weeks, at which point the graft is ready for transplantation. Ula Jurkunas, Associate Professor of Ophthalmology at HMS and Associate Scientist at the Schepens Eye Research Institute, has been working on the technique for more than a decade.

“Using the patient’s own stem cells is a big step for regenerative medicine,” said Jurkunas (1). “With this clinical trial, we hope to pave the way for better care for patients with corneal blindness.” The only treatment options currently available for patients with chemical burns are corneal transplantation – which carries risk of infection and the development of glaucoma – or conjunctival limbal autograft, which involves transplanting a portion of healthy corneal cells directly onto the affected area.

Jurkunas considers CALEC to be an ideal alternative because it carries no risk of rejection and does not require patients to take steroids or immunosuppressive medications. The patients who received the CALEC graft reported no pain, confirming the technique’s feasibility and allowing researchers to begin the second phase of the trial, which will continue through 2021.