ASCRS 2024: Management of anterior corneal disease

Ula Jurkunas, MD, sat down to discuss her presentation on the management of anterior corneal disease at this year's ASCRS meeting held in Boston, Massachusetts.

Video Transcript

Editor's note - This transcript has been edited for clarity.

David Hutton:

I'm David Hutton of Ophthalmology Times. ASCRS is holding its annual meeting this year in Boston. During the meeting, Dr. Ula Jurkunas made a presentation titled "Management of corneal disease." Thank you so much for joining me today. Tell us about your presentation.

Ula Jurkunas, MD:

Thank you very much, David for having me. So in the cornea subspecialty day, in ASCRS, we talked about management of different layers of corneal diseases. My presentation was on management of anterior corneal disease. In this presentation, I spoke about various reasons of why corneal surface can be affected, and one of the main reasons is corneal limbal stem cell deficiency that depletes stem cells that reside in the periphery of the cornea. As a result, cornea form scars, it becomes opague and vascularized and patients are affected by very blurry vision. Some of the newer technologies are to replenish the corneal surface with corneal stem cells. And when the condition of limbal stem cell deficiency is unilateral, meaning affecting only one eye, we can take stem cells from the contralateral, healthy eye, and place them on the patient's affected eye.

The newest technology is to use cultivated stem cells for that reason. So we and some other groups have developed methodologies of growing the stem cells in the laboratory after retrieving them from a patient's healthy eye. The growth and expansion of cells increases the population of stem cells that then are placed on the eye. In order for this treatment to be successful, there are quite a few steps of how the scar tissue and the conditions that are affecting the diseased eye have to be treated prior to stem cell transplantation. I went over some of the ways to lyse the symblepharon, to place an amniotic membrane, to use other eyelid reforming procedures in order to prepare the cornea for the receipt of stem cells. Having at all the stem cells placed on the eye is advantageous because they do not reject their body's own cells. And there is no need for long term use of corticosteroids. As well as taking one small biopsy decreases the risk of any stem cell problems in the good eye. Therefore, this technique is up and coming. And we're hoping that more and more centers will be able to utilize this technology when it becomes more available in the United States.

David Hutton:

And what's your take home message for this presentation?

Ula Jurkunas, MD:

My take home message is that it is most important to prepare the corneal surface by treating the eyelid abnormalities, the scar tissue in the conjunctiva, the dry eye, all the air all the things that are surrounding the cornea prior to placing stem cells