Stem Cell-Based Therapies for Corneal Blindness: A Systematic Review and Feasibility Analysis for Nigerian Application

Corneal blindness due to limbal stem cell deficiency, corneal scarring, and bullous keratopathy affects millions globally, and stem cell-based therapies represent a transformative but emerging therapeutic frontier with largely unexplored applicability in African health systems. This study conducts a systematic review of stem cell-based therapies for corneal blindness and analyses their feasibility for application in the Nigerian context. A two-phase study will be conducted. Phase one is a comprehensive systematic review and meta-analysis following PRISMA 2020 guidelines, searching PubMed, Cochrane, Embase, and African Journals Online databases for all clinical trials, cohort studies, and case series reporting outcomes of limbal stem cell transplantation, cultivated oral mucosal epithelial transplantation, and mesenchymal stem cell therapy for corneal surface disease. Primary outcomes will include visual acuity improvement, corneal epithelialisation rates, and long-term recurrence. Risk of bias will be assessed using Cochrane and ROBINS-I tools. Phase two conducts a context-specific feasibility analysis for Nigeria using a structured expert consultation process with 25 Nigerian ophthalmologists, cell biology researchers, and health technology assessment specialists. Feasibility domains assessed will include infrastructure requirements, regulatory environment, cost-effectiveness estimates, and ethical considerations. Stem cell therapy for corneal blindness is currently confined to high-income country academic centres, yet Nigeria carries a disproportionate burden of corneal blindness from agricultural injuries and trachoma. Understanding the translation pathway and contextual requirements for introducing these therapies in Nigeria makes an original and forward-looking contribution. Recommendations will address eye bank development, limbal stem cell donor programmes, and regulatory capacity building at NAFDAC. Keywords: stem cell therapy, corneal blindness, limbal stem cell deficiency, systematic review, Nigeria feasibility