ophthalmologyОфтальмологияOphthalmology in Russia1816-50952500-0845Ophthalmology10.18008/1816-5095-2026-3-557-563ophthalmology-3061Research ArticleОБЗОРЫREVIEWSАутотрансплантация жировой ткани в профилактике рубцевания после непроникающей антиглаукомной операцииAutologous Adipose Tissue Transplantation for the Prevention of Scarring After Non-Penetrating Glaucoma SurgeryНикитинВ. Н.NikitinV. N.

Никитин Владимир Николаевич, кандидат медицинских наук, врач‑офтальмохирург

ул. Академика Бардина, 4а, Екатеринбург, 620149

Nikitin Vladimir N., PhD, ophthalmic surgeon

A. Bardina str., 4A, Ekaterinburg, 620149

ИвановД. И.IvanovD. I.

Иванов Дмитрий Иванович, доктор медицинских наук, заведующий II хирургическим отделением, врач‑офтальмохирург

ул. Академика Бардина, 4а, Екатеринбург, 620149

Ivanov Dmitry I., MD, head of the Second Surgical Department, ophthalmic surgeon

A. Bardina str., 4A, Ekaterinburg, 620149

ОбодовА. В.ObodovA. V.

Ободов Андрей Викторович, врач‑офтальмохирург

ул. Академика Бардина, 4а, Екатеринбург, 620149

Obodov Andrey V., ophthalmic surgeon

A. Bardina str., 4A, Ekaterinburg, 620149

КозловаА. М.KozlovaА. M.

Козлова Анастасия Михайловна, врач‑стажер

ул. Академика Бардина, 4а, Екатеринбург, 620149

Kozlova Anastasia M., intern

A. Bardina str., 4A, Ekaterinburg, 620149

АО «ЕЦ МНТК “Микрохирургия глаза”»РоссияEye Microsurgery Ekaterinburg CenterRussian Federation202605102026233557563Copyright © Никитин В.Н., Иванов Д.И., Ободов А.В., Козлова А.М., 20262026Никитин В.Н., Иванов Д.И., Ободов А.В., Козлова А.М.Nikitin V.N., Ivanov D.I., Obodov A.V., Kozlova А.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ophthalmojournal.com/opht/article/view/3061

Рубцевание фильтрационной зоны остается главным ограничением долгосрочного успеха непроникающей антиглаукомной операции. Для фильтрующей антиглаукомной операции (НПАГХ) важны не только состояние субконъюнктивального пространства, но и функциональность трабекуло-десцеметовой мембраны, стабильность объема интрасклеральной полости и контролируемое заживление послеоперационной раны. Цель работы — сформировать клинико-патогенетическую модель рубцевания после НПАГХ и оценить, может ли аутотрансплантация жировой ткани рассматриваться как инструмент селективной иммунорегулируемой антипролиферации. Обзор выполнен в формате структурированного обзора с трансляционной направленностью на основе обзора публикаций по состоянию на март 2026 г. Анализ литературы показывает, что для НПАГХ принципиально важно не максимальное подавление клеточной активности, а управление ходом заживления. Речь идет о контроле персистирующего воспаления, TGF-b-зависимых путей, миофибробластической трансформации, ремоделирования внеклеточного матрикса и механической стабилизации фиброза. Перспективы использования жировой ткани обусловлены ее комплексным воздействием в зоне аутотрансплантации: модуляцией локального воспаления, антифибротическим эффектом, ингибированием синтеза внеклеточного матрикса, нейтрализацией матричных металлопротеиназ.

Scarring of the filtration area remains the main factor limiting the long-term success of non-penetrating glaucoma surgery (NPGS). In filtering glaucoma surgery, not only the condition of the subconjunctival space is important, but also the functionality of the trabeculoDescemet’s membrane, the stability of the intrascleral space volume, and controlled gentle postoperative wound healing. The aim of the study was to develop a clinical and pathogenetic model of scarring after NPGS and to evaluate whether autologous adipose tissue transplantation can be considered a tool for selective immunoregulatory antiproliferative modulation. The review was performed as a structured translational review based on publications available as of March 2026. Analysis of the literature demonstrates that, in NPGS, the critical factor is not maximal suppression of cellular activity, but rather regulation of the wound healing process. This includes control of persistent inflammation, TGF-b-dependent pathways, myofibroblastic transformation, extracellular matrix remodeling, and mechanical stabilization of fibrosis. The potential use of adipose tissue is associated with its complex effects within the transplantation area, including modulation of local inflammation, antifibrotic activity, inhibition of extracellular matrix synthesis, and neutralization of matrix metalloproteinases.

непроникающая глубокая склерэктомиярепарациявнеклеточный матрикспрофилактика избыточного рубцеванияаутотрансплантация жировой тканиантифибротическая модуляцияReferencesAntar S, Ashour N, Marawan M, Al-Karmalawy A. Fibrosis: types, effects, markers, mechanisms for disease progression, and its relation with oxidative stress, immunity, and inflammation. Int J Mol Sci. 2023;24(4):4004. doi: 10.3390/ijms24044004.Antar S, Ashour N, Marawan M, Al-Karmalawy A. Fibrosis: types, effects, markers, mechanisms for disease progression, and its relation with oxidative stress, immunity, and inflammation. Int J Mol Sci. 2023;24(4):4004. doi: 10.3390/ijms24044004.Lurje I, Gaisa N, Weiskirchen R, Tacke F. Mechanisms of organ fibrosis: emerging concepts and implications for novel treatment strategies. Mol Aspects Med. 2023;92:101191. doi: 10.1016/j.mam.2023.101191.Lurje I, Gaisa N, Weiskirchen R, Tacke F. Mechanisms of organ fibrosis: emerging concepts and implications for novel treatment strategies. Mol Aspects Med. 2023;92:101191. doi: 10.1016/j.mam.2023.101191.Bhattacharya M, Ramachandran P. Immunology of human fibrosis. Nat Immunol. 2023;24:1423–1433. doi: 10.1038/s41590-023-01551-9.Bhattacharya M, Ramachandran P. Immunology of human fibrosis. Nat Immunol. 2023;24:1423–1433. doi: 10.1038/s41590-023-01551-9.Murray PJ, Wynn TA. Protective and pathogenic functions of macrophage subsets. Nat Rev Immunol. 2011;11(11):723–737. doi: 10.1038/nri3073.Murray PJ, Wynn TA. Protective and pathogenic functions of macrophage subsets. Nat Rev Immunol. 2011;11(11):723–737. doi: 10.1038/nri3073.Eming SA, Wynn TA, Martin P. Inflammation and metabolism in tissue repair and regeneration. Science. 2017;356(6342):1026–1030. doi: 10.1126/science.aam7928.Eming SA, Wynn TA, Martin P. Inflammation and metabolism in tissue repair and regeneration. Science. 2017;356(6342):1026–1030. doi: 10.1126/science.aam7928.Rock KL, Latz E, Ontiveros F, Kono H. The sterile inflammatory response. Annu Rev Immunol. 2010;28:321–342. doi: 10.1146/annurev-immunol-030409-101311.Rock KL, Latz E, Ontiveros F, Kono H. The sterile inflammatory response. Annu Rev Immunol. 2010;28:321–342. doi: 10.1146/annurev-immunol-030409-101311.Chen GY, Nunez G. Sterile inflammation: sensing and reacting to damage. Nat Rev Immunol. 2010;10(12):826–837. doi: 10.1038/nri2873.Chen GY, Nunez G. Sterile inflammation: sensing and reacting to damage. Nat Rev Immunol. 2010;10(12):826–837. doi: 10.1038/nri2873.Dinarello CA. A clinical perspective of IL-1β as the gatekeeper of inflammation. Eur J Immunol. 2011;41(5):1203–1217. doi: 10.1002/eji.201141550.Dinarello CA. A clinical perspective of IL-1β as the gatekeeper of inflammation. Eur J Immunol. 2011;41(5):1203–1217. doi: 10.1002/eji.201141550.Huang E, Peng N, Xiao F, Hu D, Wang X, Lu L. The roles of immune cells in the pathogenesis of fibrosis. Int J Mol Sci. 2020;21(15):5203. doi: 10.3390/ijms21155203.Huang E, Peng N, Xiao F, Hu D, Wang X, Lu L. The roles of immune cells in the pathogenesis of fibrosis. Int J Mol Sci. 2020;21(15):5203. doi: 10.3390/ijms21155203.WynnTA. Cellular and molecular mechanisms of fibrosis. JPathol. 2008;214(2):199– 210. doi: 10.1002/path.2277.WynnTA. Cellular and molecular mechanisms of fibrosis. JPathol. 2008;214(2):199– 210. doi: 10.1002/path.2277.Hinz B. Formation and function of the myofibroblast during tissue repair. J Invest Dermatol. 2007;127(3):526–537. doi: 10.1038/sj.jid.5700613.Hinz B. Formation and function of the myofibroblast during tissue repair. J Invest Dermatol. 2007;127(3):526–537. doi: 10.1038/sj.jid.5700613.Leask A, Abraham DJ. TGF-β signaling and the fibrotic response. FASEB J. 2004;18(7):816–827. doi: 10.1096/fj.03-1273rev.Leask A, Abraham DJ. TGF-β signaling and the fibrotic response. FASEB J. 2004;18(7):816–827. doi: 10.1096/fj.03-1273rev.TheocharisAD, Skandalis SS, GialeliC, Karamanos NK. Extracellular matrix structure and function. Adv Drug Deliv Rev. 2016;97:4–27. doi: 10.1016/j.addr.2015.11.001.TheocharisAD, Skandalis SS, GialeliC, Karamanos NK. Extracellular matrix structure and function. Adv Drug Deliv Rev. 2016;97:4–27. doi: 10.1016/j.addr.2015.11.001.Humphrey JD, Dufresne ER, Schwartz MA. Mechanotransduction and extracellular matrix homeostasis. Nat Rev Mol Cell Biol. 2014;15(12):802–812. doi: 10.1038/nrm3896.Humphrey JD, Dufresne ER, Schwartz MA. Mechanotransduction and extracellular matrix homeostasis. Nat Rev Mol Cell Biol. 2014;15(12):802–812. doi: 10.1038/nrm3896.Wells RG. Tissue mechanics and fibrosis. Biochim Biophys Acta. 2013;1832(7):884– 890. doi: 10.1016/j.bbadis.2013.02.007.Wells RG. Tissue mechanics and fibrosis. Biochim Biophys Acta. 2013;1832(7):884– 890. doi: 10.1016/j.bbadis.2013.02.007.Tomasek JJ, Gabbiani G, Hinz B, Chaponnier C, Brown RA. Myofibroblasts and mechanoregulation of connective tissue remodelling. Nat Rev Mol Cell Biol. 2002;3(5):349–363. doi: 10.1038/nrm809.Tomasek JJ, Gabbiani G, Hinz B, Chaponnier C, Brown RA. Myofibroblasts and mechanoregulation of connective tissue remodelling. Nat Rev Mol Cell Biol. 2002;3(5):349–363. doi: 10.1038/nrm809.de Zawadzki A, Leeming DJ, Sanyal AJ, Anstee QM, Schattenberg JM, Friedman SL, Schuppan D, Karsdal MA. Hot and cold fibrosis: the role of serum biomarkers to assess immune mechanisms and ECM-cell interactions in human fibrosis. J Hepatol. 2025;83(1):239–257. doi: 10.1016/j.jhep.2025.02.039.de Zawadzki A, Leeming DJ, Sanyal AJ, Anstee QM, Schattenberg JM, Friedman SL, Schuppan D, Karsdal MA. Hot and cold fibrosis: the role of serum biomarkers to assess immune mechanisms and ECM-cell interactions in human fibrosis. J Hepatol. 2025;83(1):239–257. doi: 10.1016/j.jhep.2025.02.039.Schlunck G, Meyer-ter-Vehn T, Klink T, Grehn F. Conjunctival fibrosis following filtering glaucoma surgery. Exp Eye Res. 2016;142:76–82. doi: 10.1016/j.exer.2015.03.021.Schlunck G, Meyer-ter-Vehn T, Klink T, Grehn F. Conjunctival fibrosis following filtering glaucoma surgery. Exp Eye Res. 2016;142:76–82. doi: 10.1016/j.exer.2015.03.021.Skuta GL, Parrish RK. Wound healing in glaucoma filtering surgery. Surv Ophthalmol. 1987;32(3):149–170. doi: 10.1016/0039-6257(87)90091-9.Skuta GL, Parrish RK. Wound healing in glaucoma filtering surgery. Surv Ophthalmol. 1987;32(3):149–170. doi: 10.1016/0039-6257(87)90091-9.Малюгин БЭ, Сидорова АВ, Старостина АВ, Журавлев АС, Халецкая АА, Елисеева МА, Смирнова ЕА. Фармакотерапевтические подходы к управлению репаративными процессами в хирургии глаукомы. Вестник офтальмологии. 2022;138(4):136–143. doi: 10.17116/oftalma2022138041136.Malyugin BE, Sidorova AV, Starostina AV, Zhuravlev AS, Khaletskaya AA, Eliseeva MA, Smirnova EA. Pharmacological modulation of wound healing in glaucoma surgery. Russian Annals of Ophthalmology. 2022;138(4):136–143 (In Russ.). doi: 10.17116/oftalma2022138041136.Юрьева ТН, Малышева ЮВ. Особенности репаративного процесса после антиглаукомной хирургии. Национальный журнал глаукома. 2023;22(4):89–98. doi: 10.53432/20784104-2023-22-4-89-98.Yuryeva TN, Malysheva YV. Features of the reparative process after antiglaucoma surgery. National Journal glaucoma. 2023;22(4):89–98 (In Russ.). doi: 10.53432/20784104-2023-22-4-89-98.Van Bergen T, Van de Velde S, Vandewalle E, Moons L, Stalmans I. Improving patient outcomes following glaucoma surgery: state of the art and future perspectives. Clin Ophthalmol. 2014;8:857–867. doi: 10.2147/OPTH.S48745.Van Bergen T, Van de Velde S, Vandewalle E, Moons L, Stalmans I. Improving patient outcomes following glaucoma surgery: state of the art and future perspectives. Clin Ophthalmol. 2014;8:857–867. doi: 10.2147/OPTH.S48745.Holló G. Wound healing and glaucoma surgery: modulating the scarring process with conventional antimetabolites and new molecules. Dev Ophthalmol. 2017;59:80–89. doi: 10.1159/000458488.Holló G. Wound healing and glaucoma surgery: modulating the scarring process with conventional antimetabolites and new molecules. Dev Ophthalmol. 2017;59:80–89. doi: 10.1159/000458488.Lama PJ, Fechtner RD. Antifibrotics and wound healing in glaucoma surgery. Surv Ophthalmol. 2003;48(3):314–346. doi: 10.1016/S0039-6257(03)00038-9.Lama PJ, Fechtner RD. Antifibrotics and wound healing in glaucoma surgery. Surv Ophthalmol. 2003;48(3):314–346. doi: 10.1016/S0039-6257(03)00038-9.Shao CG, Sinha NR, Mohan RR, Webel AD. Novel therapies for the prevention of fibrosis in glaucoma filtration surgery. Biomedicines. 2023;11(3):657. doi: 10.3390/biomedicines11030657.Shao CG, Sinha NR, Mohan RR, Webel AD. Novel therapies for the prevention of fibrosis in glaucoma filtration surgery. Biomedicines. 2023;11(3):657. doi: 10.3390/biomedicines11030657.Mendrinos E, Mermoud A, Shaarawy T. Nonpenetrating glaucoma surgery. Surv Ophthalmol. 2008;53(6):592–630. doi: 10.1016/j.survophthal.2008.08.001.Mendrinos E, Mermoud A, Shaarawy T. Nonpenetrating glaucoma surgery. Surv Ophthalmol. 2008;53(6):592–630. doi: 10.1016/j.survophthal.2008.08.001.Abdelrahman AM. Nonpenetrating deep sclerectomy: challenges, innovations, and current evidence. Oman J Ophthalmol. 2025;18(3):267–274. doi: 10.4103/ojo.ojo_389_24.Abdelrahman AM. Nonpenetrating deep sclerectomy: challenges, innovations, and current evidence. Oman J Ophthalmol. 2025;18(3):267–274. doi: 10.4103/ojo.ojo_389_24.Rodríguez-Calvo PP, Rodríguez-Uña I, Fernández-Vega-Cueto A, SánchezÁvila RM, Anitua E, Merayo-Lloves J. Plasma rich in growth factors as an adjuvant agent in non-penetrating deep sclerectomy. J Clin Med. 2023;12(10):3604. doi: 10.3390/jcm12103604.Rodríguez-Calvo PP, Rodríguez-Uña I, Fernández-Vega-Cueto A, SánchezÁvila RM, Anitua E, Merayo-Lloves J. Plasma rich in growth factors as an adjuvant agent in non-penetrating deep sclerectomy. J Clin Med. 2023;12(10):3604. doi: 10.3390/jcm12103604.Yu-Wai-Man C, Khaw PT. Developing novel anti-fibrotic therapeutics to modulate post-surgical wound healing in glaucoma: big potential for small molecules. Expert Rev Ophthalmol. 2015;10(1):65–76. doi: 10.1586/17469899.2015.983475.Yu-Wai-Man C, Khaw PT. Developing novel anti-fibrotic therapeutics to modulate post-surgical wound healing in glaucoma: big potential for small molecules. Expert Rev Ophthalmol. 2015;10(1):65–76. doi: 10.1586/17469899.2015.983475.Dave B, Patel M, Suresh S, Ginjupalli M, Surya A, Albdour M, Kooner KS. Wound modulations in glaucoma surgery: a systematic review. Bioengineering (Basel). 2024;11(5):446. doi: 10.3390/bioengineering11050446.Dave B, Patel M, Suresh S, Ginjupalli M, Surya A, Albdour M, Kooner KS. Wound modulations in glaucoma surgery: a systematic review. Bioengineering (Basel). 2024;11(5):446. doi: 10.3390/bioengineering11050446.Lo PF, Lim ST, Wang X, Wong TT. Current challenges of managing fibrosis post glaucoma surgery and future perspectives. J Clin Med. 2025;14(23):8548. doi: 10.3390/jcm14238548.Lo PF, Lim ST, Wang X, Wong TT. Current challenges of managing fibrosis post glaucoma surgery and future perspectives. J Clin Med. 2025;14(23):8548. doi: 10.3390/jcm14238548.Sacchi M, Tomaselli D, Ruggeri ML, Aiello FB, Sabella P, Dore S, Pinna A, Mastropasqua R, Nubile M, Agnifili L. Fighting bleb fibrosis after glaucoma surgery: updated focus on key players and novel targets for therapy. Int J Mol Sci. 2025;26(5):2327. doi: 10.3390/ijms26052327.Sacchi M, Tomaselli D, Ruggeri ML, Aiello FB, Sabella P, Dore S, Pinna A, Mastropasqua R, Nubile M, Agnifili L. Fighting bleb fibrosis after glaucoma surgery: updated focus on key players and novel targets for therapy. Int J Mol Sci. 2025;26(5):2327. doi: 10.3390/ijms26052327.Khaw PT, Doyle JW, Sherwood MB, Grierson I, Schultz G, McGorray S. Prolonged localized tissue effects from 5-minute exposures to fluorouracil and mitomycin C. Arch Ophthalmol. 1993;111(2):263–267. doi: 10.1001/archopht.1993.01090020117035.Khaw PT, Doyle JW, Sherwood MB, Grierson I, Schultz G, McGorray S. Prolonged localized tissue effects from 5-minute exposures to fluorouracil and mitomycin C. Arch Ophthalmol. 1993;111(2):263–267. doi: 10.1001/archopht.1993.01090020117035.Seibold LK, Sherwood MB, Kahook MY. Wound modulation after filtration surgery. Surv Ophthalmol. 2012;57(6):530–550. doi: 10.1016/j.survophthal.2012.01.008.Seibold LK, Sherwood MB, Kahook MY. Wound modulation after filtration surgery. Surv Ophthalmol. 2012;57(6):530–550. doi: 10.1016/j.survophthal.2012.01.008.Ramji S, Tan JCK, Jarrar ZA, Hamid S, Gazzard G, Ansari AS. Trabeculectomy augmented with anti-VEGF improves surgical outcomes in glaucoma: a systematic review andmeta-analysis. AmJOphthalmol. 2025;277:184–202. doi: 10.1016/j.ajo.2025.05.005.Ramji S, Tan JCK, Jarrar ZA, Hamid S, Gazzard G, Ansari AS. Trabeculectomy augmented with anti-VEGF improves surgical outcomes in glaucoma: a systematic review andmeta-analysis. AmJOphthalmol. 2025;277:184–202. doi: 10.1016/j.ajo.2025.05.005.Dai ZX, Song XL, Yu XB, Sun JG, Sun XH. Cyclosporine A-loaded drug delivery systems inhibit scarformation after glaucoma surgery in rabbits. Chin Med J (Engl). 2019;132(11):1381–1384. doi: 10.1097/CM9.0000000000000234.Dai ZX, Song XL, Yu XB, Sun JG, Sun XH. Cyclosporine A-loaded drug delivery systems inhibit scarformation after glaucoma surgery in rabbits. Chin Med J (Engl). 2019;132(11):1381–1384. doi: 10.1097/CM9.0000000000000234.Schultz GS, Davidson JM, Kirsner RS, Bornstein P, Herman IM. Dynamic reciprocity in the wound microenvironment. Wound Repair Regen. 2011;19(2):134–148. doi: 10.1111/j.1524-475X.2011.00673.x.Schultz GS, Davidson JM, Kirsner RS, Bornstein P, Herman IM. Dynamic reciprocity in the wound microenvironment. Wound Repair Regen. 2011;19(2):134–148. doi: 10.1111/j.1524-475X.2011.00673.x.Yang F, Ji Z, Peng L, Fu T, Liu K, Dou W, Li J, Li Y, Long Y, Zhang W. Efficacy, safety and complications of autologous fat grafting to the eyelids and periorbital area: a systematic review and meta-analysis. PLoS One. 2021;16(4):e0248505. doi: 10.1371/journal.pone.0248505.Yang F, Ji Z, Peng L, Fu T, Liu K, Dou W, Li J, Li Y, Long Y, Zhang W. Efficacy, safety and complications of autologous fat grafting to the eyelids and periorbital area: a systematic review and meta-analysis. PLoS One. 2021;16(4):e0248505. doi: 10.1371/journal.pone.0248505.Sidhu N, Agrawal S, Pushker N, Bhari N, Meel R, Bajaj MS. Autologous fat transfer for orbital volume augmentation in sockets with small nonseeing eyes. J Plast Reconstr Aesthet Surg. 2023;82:170–175. doi: 10.1016/j.bjps.2023.02.024.Sidhu N, Agrawal S, Pushker N, Bhari N, Meel R, Bajaj MS. Autologous fat transfer for orbital volume augmentation in sockets with small nonseeing eyes. J Plast Reconstr Aesthet Surg. 2023;82:170–175. doi: 10.1016/j.bjps.2023.02.024.Yu W, Wang Z, Dai Y, Zhao S, Chen H, Wang S, Xie H. Autologous fat grafting for postoperative breast reconstruction: a systemic review. Regen Ther. 2024;26:1010– 1017. doi: 10.1016/j.reth.2024.10.007.Yu W, Wang Z, Dai Y, Zhao S, Chen H, Wang S, Xie H. Autologous fat grafting for postoperative breast reconstruction: a systemic review. Regen Ther. 2024;26:1010– 1017. doi: 10.1016/j.reth.2024.10.007.Nasim S, Nasim H, Kauke M, Safi AF. Autologous fat grafting for cosmetic temporal augmentation: a systematic review. Front Surg. 2024;11:1410162. doi: 10.3389/fsurg.2024.1410162.Nasim S, Nasim H, Kauke M, Safi AF. Autologous fat grafting for cosmetic temporal augmentation: a systematic review. Front Surg. 2024;11:1410162. doi: 10.3389/fsurg.2024.1410162.Gornitsky J, Viezel-Mathieu A, Alnaif N, Azzi AJ, Gilardino MS. A systematic review of the effectiveness and complications of fat grafting in the facial region. JPRAS Open. 2019;19:87–97. doi: 10.1016/j.jpra.2018.12.004.Gornitsky J, Viezel-Mathieu A, Alnaif N, Azzi AJ, Gilardino MS. A systematic review of the effectiveness and complications of fat grafting in the facial region. JPRAS Open. 2019;19:87–97. doi: 10.1016/j.jpra.2018.12.004.Zuk PA, Zhu M, Mizuno H, et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001;7(2):211–228. doi: 10.1089/107632701300062859.Zuk PA, Zhu M, Mizuno H, et al. Multilineage cells from human adipose tissue: implications for cell-based therapies. Tissue Eng. 2001;7(2):211–228. doi: 10.1089/107632701300062859.Gimble JM, Katz AJ, Bunnell BA. Adipose-derived stem cells for regenerative medicine. Circ Res. 2007;100(9):1249–1260. doi: 10.1161/01.RES.0000265074.83288.09.Gimble JM, Katz AJ, Bunnell BA. Adipose-derived stem cells for regenerative medicine. Circ Res. 2007;100(9):1249–1260. doi: 10.1161/01.RES.0000265074.83288.09.Musa M, Zeppieri M, Enaholo ES, Salati C, Parodi PC. Adipose stem cells in modern-day ophthalmology. Clin Pract. 2023;13(1):230–245. doi: 10.3390/clinpract13010021.Musa M, Zeppieri M, Enaholo ES, Salati C, Parodi PC. Adipose stem cells in modern-day ophthalmology. Clin Pract. 2023;13(1):230–245. doi: 10.3390/clinpract13010021.Surico PL, Sarnicola C, Niculescu AG, et al. Adipose-derived mesenchymal stem cells in ocular surface reconstruction and oculoplastics. World J Stem Cells. 2024;16(2):89–108. doi: 10.4252/wjsc.v16.i2.89.Surico PL, Sarnicola C, Niculescu AG, et al. Adipose-derived mesenchymal stem cells in ocular surface reconstruction and oculoplastics. World J Stem Cells. 2024;16(2):89–108. doi: 10.4252/wjsc.v16.i2.89.Caplan AI, Correa D. The MSC: an injury drugstore. Cell Stem Cell. 2011;9(1):11– 15. doi: 10.1016/j.stem.2011.06.008.Caplan AI, Correa D. The MSC: an injury drugstore. Cell Stem Cell. 2011;9(1):11– 15. doi: 10.1016/j.stem.2011.06.008.Frommer ML, Langridge BJ, Beedie A, Jasionowska S, Awad L, Denton CP, Abraham DJ, Abu-Hanna J, Butler PEM. Exploring anti-fibrotic effects of adipose-derived stem cells: transcriptome analysis upon fibrotic, inflammatory, and hypoxic conditioning. Cells. 2024;13(8):693. doi: 10.3390/cells13080693.Frommer ML, Langridge BJ, Beedie A, Jasionowska S, Awad L, Denton CP, Abraham DJ, Abu-Hanna J, Butler PEM. Exploring anti-fibrotic effects of adipose-derived stem cells: transcriptome analysis upon fibrotic, inflammatory, and hypoxic conditioning. Cells. 2024;13(8):693. doi: 10.3390/cells13080693.Ma C, Li Y, Liu B, Deng J, Gao X, Zhang H, Zhang B, Zhou Q, Peng X, Zhang H. Exosomes derived from adipose mesenchymal stem cells promote corneal injury repair and inhibit the formation of scars by anti-apoptosis. Colloids Surf B Biointerfaces. 2025;247:114454. doi: 10.1016/j.colsurfb.2025.114454.Ma C, Li Y, Liu B, Deng J, Gao X, Zhang H, Zhang B, Zhou Q, Peng X, Zhang H. Exosomes derived from adipose mesenchymal stem cells promote corneal injury repair and inhibit the formation of scars by anti-apoptosis. Colloids Surf B Biointerfaces. 2025;247:114454. doi: 10.1016/j.colsurfb.2025.114454.Cheng S, Ma Y, Huang F, Luo R, Han L, He L, Yuan ZX. Mesenchymal stem cell-derived exosomes for ocular diseases: therapeutic mechanisms and clinical perspectives. Int J Nanomedicine. 2025;20:14521–14550. doi: 10.2147/IJN.S555771.Cheng S, Ma Y, Huang F, Luo R, Han L, He L, Yuan ZX. Mesenchymal stem cell-derived exosomes for ocular diseases: therapeutic mechanisms and clinical perspectives. Int J Nanomedicine. 2025;20:14521–14550. doi: 10.2147/IJN.S555771.Kølle SF, Fischer-Nielsen A, Mathiasen AB, Elberg JJ, Oliveri RS, Glovinski PV, Kastrup J, Kirchhoff M, Rasmussen BS, Talman ML, Thomsen C, Dickmeiss E, Drzewiecki KT. Enrichment of autologous fat grafts with ex vivo expanded adipose tissue-derived stem cells for graft survival: a randomized placebo-controlled trial. Lancet. 2013;382(9898):1113–1120. doi: 10.1016/S0140-6736(13)61410-5.Kølle SF, Fischer-Nielsen A, Mathiasen AB, Elberg JJ, Oliveri RS, Glovinski PV, Kastrup J, Kirchhoff M, Rasmussen BS, Talman ML, Thomsen C, Dickmeiss E, Drzewiecki KT. Enrichment of autologous fat grafts with ex vivo expanded adipose tissue-derived stem cells for graft survival: a randomized placebo-controlled trial. Lancet. 2013;382(9898):1113–1120. doi: 10.1016/S0140-6736(13)61410-5.Mousa ASG. Preliminary evaluation of nonpenetrating deep sclerectomy with autologous scleral implant in open-angle glaucoma. Eye (Lond). 2007;21(9):1234– 1238. doi: 10.1038/sj.eye.6702571.Mousa ASG. Preliminary evaluation of nonpenetrating deep sclerectomy with autologous scleral implant in open-angle glaucoma. Eye (Lond). 2007;21(9):1234– 1238. doi: 10.1038/sj.eye.6702571.Mead B, Tomarev S. Bone marrow-derived mesenchymal stem cells-derived exosomes promote survival of retinal ganglion cells through miRNA-dependent mechanisms. Stem Cells Transl Med. 2017;6(4):1273–1285. doi: 10.1002/sctm.160428.Mead B, Tomarev S. Bone marrow-derived mesenchymal stem cells-derived exosomes promote survival of retinal ganglion cells through miRNA-dependent mechanisms. Stem Cells Transl Med. 2017;6(4):1273–1285. doi: 10.1002/sctm.160428.Wu D, Liu Y, Zhang X, Zhang R, Wang S, Lu H, Yue T. Efficacy and safety of stem cells in the treatment of glaucoma: systematic review and meta-analysis based on animal experiments. Front Pharmacol. 2025;16:1587440. doi: 10.3389/fphar.2025.1587440.Wu D, Liu Y, Zhang X, Zhang R, Wang S, Lu H, Yue T. Efficacy and safety of stem cells in the treatment of glaucoma: systematic review and meta-analysis based on animal experiments. Front Pharmacol. 2025;16:1587440. doi: 10.3389/fphar.2025.1587440.

The authors declare that there are no conflicts of interest present.