Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
Pinnita Prabhasawat,1 Pattama Ekpo,2 Mongkol Uiprasertkul,3 Suksri Chotikavanich,1 Nattaporn Tesavibul1
1Department of Ophthalmology, 2Department of Immunology, 3Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Purpose: To investigate the clinical outcomes of cultivated corneal limbal epithelial transplantation (CLET) using human amniotic membrane for corneal limbal stem-cell deficiency.
Methods: Prospective, noncomparative case series. Eighteen patients (19 eyes) with severe ocular surface diseases were chosen to undergo CLET using human amniotic membrane. Twelve eyes received auto-CLET, and seven eyes received allo-CLET. Clinical outcomes of corneal surface epithelialization, conjunctivalization, inflammation, visual acuity, graft status, and complications were observed.
Results: Corneal epithelium cultivated on amniotic membrane (two to four layers) was positive for molecular markers p63, ABCG2, CK3, and CK12. The mean patient age was 44.7 ± 15.2 years. A successful clinical outcome, defined as corneal epithelialization without central conjunctivalization or severe inflammation, was obtained in 14 (73.7%) of 19 eyes (mean follow-up 26.1 ± 13.5 months; range 6–47). A histopathologic success, defined as absence of goblet cells at the central cornea, was achieved in 12 (63.2%) eyes. Clinical failures occurred in five (26.3%) of 19 eyes, and histopathologic failures occurred in seven (36.8%) of 19 eyes. Survival analysis at 1 year showed that the clinical success rate was 77.9% and the pathological success rate was 72.3%. Fourteen of 19 (73.7%) eyes had visual acuity improvements after CLET. Six cases underwent penetrating keratoplasty; five of these grafts remained clear after 20.4 ± 6.9 months (range, 12–31) of follow-up. Complications included infectious keratitis (three cases) and recurrent symblepharon (one case). All complicated cases had lid abnormalities. Factors affecting the final clinical outcomes were lid abnormalities, abnormal corneal stromal beds, and complications.
Conclusion: CLET can successfully restore ocular surface damage in most cases with corneal limbal stem cell deficiency.
Keywords: limbal deficiency, limbal transplantation, corneal epithelial stem-cell transplantation, cultivated corneal epithelial stem cells
This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php
Readers of this article also read:
Regenerative treatment using a radioelectric asymmetric conveyor as a novel tool in antiaging medicine: an in vitro beta-galactosidase study
Rinaldi S, Maioli M, Santaniello S, Castagna A, Pigliaru GF, Gualini S, Margotti ML, Carta A, Fontani V, Ventura C
Published Date: 29 June 2012
Published Date: 8 August 2012
Tautzenberger A, Kovtun A, Ignatius A
Published Date: 17 August 2012
Critical appraisal of biosimilar filgrastim (Nivestim™) for febrile and chemotherapy-induced neutropenia
Published Date: 20 August 2012
High sensitivity C-reactive protein: a biomarker for heart failure in children with univentricular heart disease
Lowenthal A, Natal-Hernandez L, Lowenthal S, Hills NK, Bernstein HS
Published Date: 29 August 2012
Published Date: 4 September 2012
Sweating of Descemet's membrane during deep anterior lamellar keratoplasty in absence of perforation
Mohamed-Noriega K, Mehta JS
Published Date: 5 September 2012
Shah M, Allegrucci C
Published Date: 26 October 2012
Published Date: 5 December 2012