2026-06-30 | 3% diquafosol sodium combined with 0.1% fluorometholone for postoperative dry eye in pterygium patients with preoperative tear deficiency: a pilot retrospective study
Background To evaluate the clinical efficacy and safety of 3% diquafosol sodium combined with 0.1% fluorometholone for postoperative dry eye in pterygium patients with preoperative tear deficiency. Methods This single-center retrospective study included 82 pterygium patients (82 eyes) with preoperative tear deficiency who underwent pterygium excision combined with limbal stem cell transplantation. Patients were divided into an observation group (diquafosol + fluorometholone, n = 42) and a control group (sodium hyaluronate + fluorometholone, n = 40). Tear break-up time (BUT), corneal fluorescein staining (CFS) score, Ocular Surface Disease Index (OSDI), Schirmer I test (SIt), and intraocular pressure (IOP) were assessed preoperatively and at 2 and 4 weeks postoperatively. Adverse events and complications were recorded. Results Eighty patients completed follow-up (41 in observation group, 39 in control group). At 4 weeks postoperatively, the observation group showed significantly longer BUT, lower CFS and OSDI scores, and higher SIt values compared to the control group (all p < 0.05). No significant intergroup differences in IOP were observed at any time point. Transient ocular stinging occurred in 2 patients (4.88%) in the observation group, with no severe complications in either group. Conclusion In this pilot study, the combination of 3% diquafosol sodium and 0.1% fluorometholone showed preliminary evidence of improving tear film stability, repairing ocular surface damage, and alleviating dry eye symptoms in pterygium patients with preoperative tear deficiency, without significantly affecting IOP. Its efficacy appeared superior to sodium hyaluronate combined with fluorometholone. These findings support further investigation in larger, longer-term randomized controlled trials.
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2026-06-26 | Induced Pluripotent Stem Cells in Corneal Regeneration: Biological Progress, Translational Barriers and Clinical Outlook.
Corneal blindness remains a major cause of visual impairment worldwide and may result from trauma, infectious keratitis, degenerative disorders, endothelial dysfunction, and limbal stem cell deficiency (LSCD). Although corneal transplantation remains the standard treatment for advanced disease, its effectiveness is limited by donor tissue shortage, immune-mediated rejection, postoperative complications, and progressive graft failure. These limitations have accelerated interest in regenerative approaches aimed at restoring native corneal structure and function. Induced pluripotent stem cells (iPSCs) have emerged as a promising platform for corneal regeneration because of their pluripotency, self-renewal capacity, and potential for autologous or immune-compatible therapy. Recent advances in differentiation protocols have enabled the generation of corneal epithelial-like cells, stromal keratocyte-like cells, and corneal endothelial-like cells from iPSCs. Preclinical studies have demonstrated encouraging improvements in corneal transparency, epithelial restoration, fibrosis reduction, and endothelial function, while early clinical investigations, particularly in LSCD, have reported favorable short-term safety and functional outcomes. However, major translational barriers remain, including tumorigenicity, immunogenicity, genomic instability, manufacturing complexity, scalability, and long-term safety concerns. Stromal regeneration also remains comparatively underdeveloped relative to epithelial and endothelial applications. This review summarizes current differentiation strategies, biological mechanisms, preclinical and early clinical evidence, and the principal translational challenges associated with iPSC-based corneal regeneration. Overall, iPSC-derived corneal therapies demonstrate considerable regenerative potential, although further standardization, long-term safety evaluation, and multicenter clinical validation remain necessary before widespread clinical adoption.
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2026-06-13 | Current Practices, Evolving Techniques, and Immunologic Challenges in Living and Deceased Donor Limbal Stem Cell Transplantation.
This review focuses on allogeneic sources for restoring the ocular surface using limbal stem cell transplantation. We outline the current practices, evolving techniques, and immunologic challenges in living-related and deceased donor limbal stem cell transplantation. The diagnosis and staging guidelines for limbal stem cell deficiency are reviewed. We also explore the currently available treatment approaches, including the Cincinnati protocol for donor/recipient selection criteria and systemic immunosuppression (SI) regimen. Utilization of panel reactive antibody, HLA typing, ABO typing, and donor specific antibodies are highlighted. The traditional techniques as well as more novel variations are described. The importance of 3-agent SI protocols and patient adherence are emphasized to ensure excellent long-term outcomes. The primary immunologic challenge of allogeneic limbal stem cell transplantation, rejection, is also discussed in detail with recommended treatments, including a newer role for intravenous immunoglobulin. Other evolving practices have included a greater reliance on living-related conjunctival limbal allograft over deceased donor keratolimbal allograft due to improved outcomes, decreasing SI in older populations, and lengthening SI regimens due to the possibility of late acute rejection. Finally, we discuss the future of restoring the ocular surface via cell-based therapies, which may have the potential to decrease rejection.
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