Purchase this article with an account.
J. Shimazaki, M. Aiba, S. Shimmura, K. Tsubota; Transplantation of cultivated limbal and conjunctival epithelium for various ocular surface disorders . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3941.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To investigate intermediate clinical outcome of cultivated limbal epithelial (CLET) and conjunctival epithelial transplantation (CCET) for various ocular surface disorders. Methods: Consecutive 43 cases (30 eyes) transplanted with cell sheets cultivated on preserved amniotic membrane were analyzed. Cell source was either limbal (n=32) or conjunctival (n=11) epithelium. Cultivation was performed using SHEM media and 10% patient serum. The patients included 29 males and 14 females ranging from 13 to 82 years of age (mean; 47.2 ± 19.4). The most common original disease was Stevens–Johnson syndrome (SJS, n=28), followed by chemical or thermal burns (n=10). Transplantation was performed for the treatment of persistent epithelial defects (PED group, n=14) or for visual recovery in conjunctivalized eyes (Conjunctiva group, n=18). In CLET, limbal tissue was obtained from the patients' opposite eye (n=5), from living–related donors (n=11), and cadavor eyes (n=16). In CCET, conjunctiva was obtained from opposite eyes (n=9) or from living–related donors (n=2). Results: Successful cultivation of the epithelium was achieved in 28 of 32 cases (87.5%) in CLET and 8 of 11 cases (72.7%) in CCET. Cultivation of auto–tissue was least successful (57.1%) followed by living–relatives (92.3%) and allo–tissue (100%). Postoperative epithelialization was noted in 16/28 eyes (57.1%) in CLET and 2/8 (25.0%) in CCET. SJS showed lower success rate in epithelialization (32.0%) compared with burns (100%). PED group had less chance of epithelialization (2/14, 14.7%) compared with Conjunctiva group (16/18, 88.9%). Conclusions: Results of cultivation or transplantation of ocular surface epithelia varies among different cases. While cultivated limbal or conjunctival epithelial sheets can be obtained in most cases, cultivation of cells derived from diseased eyes was difficult. Eyes with either prolonged infammation such as in SJS, or with persistent epithelial defects were resistant to be epithelialized after transplantation. This research was supported by a Grant of the Ministry of Health and Welfare, Japan (H15–Saisei–011).
This PDF is available to Subscribers Only