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T. Inatomi, T. Nakamura, N. Koizumi, C. Sotozono, S. Kinoshita; Effect of Autologous Cultivated Oral Mucosal Epithelial Transplantation on Ocular Surface Reconstruction . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4960.
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© ARVO (1962-2015); The Authors (2016-present)
To report on the efficacy and long term results of autologous cultivated oral mucosal epithelial sheet transplantation (COMET) on ocular surface and conjunctival reconstruction in severe ocular surface disorders.
Clinical outcomes of COMET are evaluated retrospectively. Subjects involve 32 eyes in 29 cases including 7 eyes of chemical burn, 12 eyes of Stevens–Johnson syndrome and 5 eyes of ocular pemphigoid and 2 eyes of ocular tumors. The mean age is 49.1 years and observation period is 21 months. After removal of inflamed subconjunctival tissues and treatment with intraoperative 0.04% MMC, 19 eyes in 16 cases (59%) received ocular surface reconstruction and 13 eyes in 13 cases (41%) received conjunctival reconstruction using COMET.
97% of cultivated oral mucosal epithelial sheets were completely stratified. All corneal surfaces were re–epithelialized with cultivated epithelium. The best visual acuity in the ocular surface reconstruction group was 0.6, and visual acuity of 7 eyes (37%) improved better than 0.1. Post operative complications involved 7 eyes of persistent epithelial defect and one eye of corneal infection. Only 2 eyes in one case required re–operation. In the conjunctival reconstruction group, no recurrences of cicatrisation in subconjunctival spaces were observed in 10 eyes (77%), but one eye (8%) and 2 eyes (15%) showed mild and moderate recurrence of fibrosis.
Ocular surface in stem cell deficiency was reconstructed using tissue engineered autologous oral mucosal epithelial sheet transplantation. Clinical application of autologous oral mucosal epithelial transplantation improves the clinical outcome and prevents cicatrisation, reducing post–operative complications associated with immunosuppressions.
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