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The usual treatment of corneal tissue alteration is penetrating corneal grafting, but human cadaver donor corneas cannot always satisfy the demand for grafts and most particularly limbic deficiencies will always be rejected. It has led to the development of new therapeutic strategies for corneal repair. A breakthrough in tissue engineering occurred in 1975 when skin stem cells were successfully amplified in culture by Rheinwald and Green. A similar technique has been later adapted to the amplification of limbal then oral mucosa epithelial cells for the treatment of unilateral limbal epithelial stem cell deficiency (LSCD). For bilateral LSCD, oral mucosa epithelial cell sheets are now proposed. The sheets bring a functional epithelium able to push back conjunctivalization and neovascularisation.
Beside clinical applications, tissue engineering enable the reconstruction of three-dimensional (3D) complex tissues comprising an epithelium, a stroma and occasionally an endothelium for research and pharmacotoxicological applications.
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