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T. Inatomi, N. Koizumi, T. Nakamura, C. Sotozono, S. Kinoshita; Ocular Surface Reconstruction in Acute Phase of Ocular Surface Disorders Using Cultivated Corneal Stem Cell Transplantation . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4678.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report the outcome of cultivated corneal epithelial transplantation from corneal stem cell using amniotic membrane (AM) in acute phase of severe stem cell deficiencies. Methods: Corneal limbal epithelium from donor corneas including corneal stem cells was cultivated for 3 to 4 weeks on a denuded AM carrier, with 3T3 fibroblast co-culture and air lifting. The cultivated corneal epithelium showed four to five layers of stratification and was well differentiated expressing keratin 3 and 12. After conjunctival tissue removal from the cornea, up to 3 mm outside the limbus, the cultivated allocorneal epithelial sheet on AM was transplanted onto this corneal surface up to the limbus. Nine eyes of 7 patients suffering acute phase of ocular surface disorders were studied. These consisted of five eyes with acute Stevens-Johnson syndrome (SJS), three with an acute chemical injury, one with ocular cicatricial pemphigoid. All cases showed persistent corneal epithelial defect and severe inflammation which are resistant to the conventional treatment. Results: In all 9 eyes, the entire corneal surface, on which cultivated allocorneal epithelium had been placed, was free from epithelial defects and severe inflammation 48 hours after surgery, indicating complete survival of the transplanted corneal epithelium. Three eyes required re-operation because of rejection or epithelial opacity. During the follow-up (average 25.5 month), inflammation and cicatrisation of the ocular surfaces had lessened. No symblepharon was observed in all cases. Conclusions: Cultivated corneal epithelial transplantation using denuded AM as a carrier is a feasible method for ocular surface reconstruction in acute phase of severe stem cell deficiencies. This method reduces scarring and heals more quickly than conventional epithelial transplantation.
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