RRC ID 45078
Author Sotozono C, Inatomi T, Nakamura T, Koizumi N, Yokoi N, Ueta M, Matsuyama K, Kaneda H, Fukushima M, Kinoshita S.
Title Cultivated oral mucosal epithelial transplantation for persistent epithelial defect in severe ocular surface diseases with acute inflammatory activity.
Journal Acta Ophthalmol
Abstract PURPOSE:To assess the clinical efficacy of cultivated oral mucosal epithelial transplantation (COMET) for the treatment of persistent epithelial defect (PED).
METHODS:We treated 10 eyes of nine patients with PED (Stevens-Johnson syndrome: three eyes; thermal/chemical injury: five eyes; ocular cicatricial pemphigoid: two eyes) with COMET at Kyoto Prefectural University of Medicine, Kyoto, Japan from 2002 to 2008.
RESULTS:Preoperatively, PED existed on over more than 50% of the corneal surface in seven eyes. Severe ocular surface inflammation with fibrovascular tissue surrounded the PED in all 10 eyes. At 24-weeks postoperative, PED had improved in all cases except 1 in which the patient was unable to return to the hospital (95% CI, 55.5-99.7; Wilcoxon signed-rank test, p = 0.0078). The preoperative median of logarithmic minimum angle of resolution was 1.85 (range 0.15-2.70), and 1.85, 1.85, and 1.52 at the 4th, 12th, and 24th postoperative week, respectively. The mean total preoperative ocular surface grading score was 7.0 (range 4-17). At 4 and 12 weeks postoperative, the total ocular surface grading score had improved significantly (p = 0.0020, p = 0.0078), and at 24 weeks postoperative, it was 3.0 (range 2-12, p = 0.0234). During the follow-up period (median 23.3 months, range 5.6-39.7 months), no recurrence of PED was observed in any eye, and long-term ocular surface stability was obtained.
CONCLUSION:COMET enabled complete epithelialization of PED and stabilization of the ocular surface in patients with severe ocular surface disease, thus preventing end-stage cicatrization and vision loss at a later stage.
Volume 92(6)
Pages e447-53
Published 2014-9
DOI 10.1111/aos.12397
PMID 24835597
PMC PMC4329382
MeSH Acute Disease Adult Aged Aged, 80 and over Burns, Chemical / pathology Burns, Chemical / surgery* Cell Transplantation Cells, Cultured Child Corneal Injuries / pathology Corneal Injuries / surgery* Epithelial Cells / transplantation* Eye Burns / chemically induced* Eye Burns / pathology Female Humans Male Middle Aged Mouth Mucosa / cytology* Pemphigoid, Benign Mucous Membrane / pathology Pemphigoid, Benign Mucous Membrane / surgery* Re-Epithelialization Stevens-Johnson Syndrome / pathology Stevens-Johnson Syndrome / surgery* Visual Acuity
IF 3.324
Times Cited 14
Human and Animal Cells