Doctors perform living donor stem cell transplants in eye patients

May 5, 2014 by Jim Ritter

Debra Astrug, who once feared she was going blind, can see fine now, thanks to a stem cell transplant she received from her daughter, Jessica.

The stem cells came from two pieces of tissue that Dr. Charles Bouchard of Loyola University Medical Center removed from the cornea of Jessica's left . When Bouchard proposed the innovative procedure, she immediately agreed.

"It's my mom," Jessica said. "If she needs part of my eye, she's got it."

Before the transplant, Debra Astrug's vision was extremely blurred – like looking through a glass smeared with Vaseline. She could not read or drive. And when Jessica took her to buy groceries, Debra had to bring a magnifying glass to read labels.

"It was horrible," she said.

But since receiving the stem cell transplant, and wearing special contact lenses, Debra Astrug's vision has improved to 20/25.

Loyola is among a handful of centers that perform living-related corneal stem cell transplants on patients who have too few corneal stem cells. Ophthalmologists traditionally have treated such deficiencies by transplanting stem cells from deceased donors. In these cases, in order to prevent the patient's immune system from rejecting the donated stem cells, patients take immune-suppressing drugs for several years or longer. But such drugs can have toxic side effects and also increase the risk of infections, said Bouchard, who is chair of Loyola's Department of Ophthalmology.

Bouchard is performing corneal/limbal from living donors who are first-degree relatives of patients. Because the donor and recipient are closely related, most patients can avoid taking systemic immune-suppressing drugs.

Stem are the treatment of choice for patients who have severe cases of limbal stem cell deficiency, or LSCD. (Limbal refers to the border of the cornea and sclera. The cornea is the transparent front part of the eye, and the sclera is the white part of the eye.)

Stem cells are undifferentiated cells that have the ability to develop into specialized cells. For example, if the cornea is scratched, stem cells generate new cells that migrate to the damaged area and then divide and mature into corneal cells to repair the damage.

In LSCD, the cornea becomes covered with abnormal vascularized tissue that has migrated from the conjunctiva (the mucus covering the white part of the eye). LSCD can be due to various causes, including a chemical burn; a severe whole-body allergic reaction to medications called Stevens-Johnson syndrome /toxic epidermal necrolysis; multiple eye surgeries; and long-term use of eye drop medications.

In Astrug's case, the stem cell deficiency was due to graft-versus-host disease, a side effect of a bone marrow transplant that successfully treated a prior cancer.

In a living-related corneal donor transplant, Bouchard scrapes away abnormal tissue from the patient's eye. From the donor's eye, he removes two tiny slices of tissue, which contain . He transplants them into the recipient's eye, attaching them with biologic glue. The tissue taken from the donor eye grows back in about a month.

Jessica Astrug donated tissue as an outpatient procedure. Her only discomfort came from the stitches, which were removed after two weeks. The donation had no effect on her vision. "It's like it never happened," she said.

Debra Astrug said she experienced only minor pain after the transplant. "I took ibuprofen and I was fine."

Debra Astrug said any of her three grown children would have donated. Jessica was the logical choice because she lives the closest. Debra Astrug, 56, lives in Elgin, Ill. Jessica Astrug, 31, lives in Pingree Grove.

"It's something families do for one another," Debra said. "I would lay down my life for my children."

Bouchard said a living-related corneal stem cell transplant can restore good-to-excellent vision, without putting the patient at risk from the side effects of immune-suppressing drugs.

"This procedure is an example of the state-of-the-art surgical techniques that Loyola's corneal services can provide to with more complex eye problems," Bouchard said.

Explore further: Scientists design and test new approach for corneal stem cell treatments

Related Stories

Scientists design and test new approach for corneal stem cell treatments

November 27, 2013
Researchers in the Cedars-Sinai Regenerative Medicine Institute have designed and tested a novel, minute-long procedure to prepare human amniotic membrane for use as a scaffold for specialized stem cells that may be used ...

Two patients in Scotland get stem cell transplants to treat blindness

May 22, 2012
(Medical Xpress) -- Two people in Scotland have received stem cell transplants into their eyes in a clinical trial that is aimed at restoring vision in people that suffer some degree of blindness due to damage to the cornea. ...

New technique to deliver stem cell therapy may help damaged eyes regain their sight

December 5, 2012
In research published in the journal Acta Biomaterialia, researchers from the University of Sheffield describe a new method for producing membranes to help in the grafting of stem cells onto the eye, mimicking structural ...

New cells found that could help save people's sight

November 8, 2012
Eye experts and scientists at the University of Southampton have discovered specific cells in the eye which could lead to a new procedure to treat and cure blinding eye conditions.

First corneal transplant with pre-loaded donor tissue performed at Mass. Eye and Ear

May 7, 2013
The first successful cornea transplant with donor endothelial tissue preloaded by an eye bank has been performed at Massachusetts Eye and Ear in Boston, Mass. Roberto Pineda II, M.D., Director of the Refractive Surgery Service ...

Recommended for you

Genome editing with CRISPR-Cas9 prevents angiogenesis of the retina

July 24, 2017
A research team from the Schepens Eye Research Institute of Massachusetts Eye and Ear has successfully prevented mice from developing angiogenesis of the retina—the sensory tissue at the back of the eye—using gene-editing ...

Too little vitamin D may hinder recovery of injured corneas

July 24, 2017
Injury or disease in combination with too little vitamin D can be bad for the window to your eyes.

Combination of type 2 diabetes and sleep apnoea indicates eyesight loss within four years

July 4, 2017
Research led by the University of Birmingham has discovered that patients who suffer from both Type 2 diabetes and obstructive sleep apnoea are at greater risk of developing a condition that leads to blindness within an average ...

Nearly 60% of pinkeye patients receive antibiotic eye drops, but they're seldom necessary

June 28, 2017
A new study suggests that most people with acute conjunctivitis, or pinkeye, are getting the wrong treatment.

Magnetic implants used to treat 'dancing eyes'

June 26, 2017
A research team has successfully used magnets implanted behind a person's eyes to treat nystagmus, a condition characterised by involuntary eye movements.

Drug shows promise against vision-robbing disease in seniors

June 21, 2017
An experimental drug is showing promise against an untreatable eye disease that blinds older adults—and intriguingly, it seems to work in patients who carry a particular gene flaw that fuels the damage to their vision.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.