Abstract
Purpose: :
To investigate the long-term outcome of autologous cultivated oral mucosal epithelial transplantation for the treatment of severe ocular surface disorders.
Methods: :
This study involved 35 eyes of 33 patients who received autologous cultivated oral mucosal epithelial transplantation for total limbal stem cell deficiency. Autologous cultivated oral mucosal epithelial sheets were created using amniotic membrane as a substrate. The clinical results (visual acuity, conjunctivalization, neovascularization, symblepharon, graft survival, and postoperative complications, etc.) were evaluated and graded on a scale from 0 to 3 according to their severity.
Results: :
Autologous cultivated oral mucosal epithelial sheets were successfully generated from all 33 patients. The patients were followed-up for a mean period of 36 months; the longest follow-up period was 76 months. During the long-term follow-up period, postoperative conjunctivalization and symblepharon were significantly inhibited. In almost all cases, the ectopically transplanted cultivated oral mucosal epithelium survived on the ocular surface. All eyes manifested various degrees of superficial corneal vascularization, but it gradually abated and its activity was stable at 6 months after surgery. In 12 of 31 eyes (38%), postoperative visual acuity had improved by more than 2 lines at the time of the last follow-up visit.
Conclusions: :
These long-term clinical results strongly support the conclusion that tissue-engineered cultivated oral mucosal epithelial sheets are useful in reconstructing the ocular surface of severe ocular surface disorders.
Clinical Trial: :
www.umin.ac.jp/ctr/index/htm 20081202-002044
Keywords: cornea: clinical science • cornea: epithelium • conjunctiva