Purchase this article with an account.
Y. Satake, M. Aiba, M. Dogru, T. Sumi, M. Tomita, K. Higa, S. Shimmura, K. Tsubota, J. Shimazaki; Barrier Function and Epithelial Phenotype Following Cultivated Oral Mucosal Epithelial Transplantation . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4987.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: The corneal epithelium serves not only as the major refractive surface of the eye but also as a barrier to pathogen entrance. We examined the barrier function and the epithelial phenotype of ocular surface epithelia after cultivated oral mucosa epithelial transplantation. Methods: Anterior fluorophotometry was performed to examine the epithelial permeability of 4 eyes (pseudo–OCP: 2 eyes, Stevens–Johnson syndrome: 1 eye, chemical burn: 1 eye) with total limbal dysfunction before and after cultivated oral mucosal epithelial sheet transplantation . Impression cytology specimens of transplanted area were also examined after surgery using PAS–hematoxylin stain. Results: All eyes achieved clinically stable ocular surfaces postoperatively. The average fluorescein concentrations at each time point were as follows: Case 1 (pOCP): 802.5 ng/ml at preoperatively and 3708.4 ng/ml at 3 months (M) postoperatively. Case 2 (pOCP): 2713.5 ng/ml and 4905.8 ng/ml respectively. Case 3 (SJS): preoperative measurement was not available and above the detection limit at 1.5 and 8.5 M postoperatively. Case 4 (chemical burn): preoperative measurement was not available and 1541.1 ng/ml at 3 weeks postoperatively just after complete epithelialization from a total epithelial defect. The oral mucosal epithelial phenotype was detected on the transplanted surface at even 10 M postoperatively (Case 3). The conjunctival epithelial phenotype with goblet cells was found at the periphery of the transplanted sheet in 2 cases (Case 1: 3M, Case 3: 4.5 & 10 M). Inflammatory cells were also detected at the center of transplanted sheet in 1 case (Case 3: 4.5 M). In the case that healed from a total epithelial defect (Case 4: 8 M), conjunctival epithelia were predominant but oral mucosal epithelia were also detected. Conclusions: The cultivated oral mucosal epithelial transplantation is a recently developed procedure and showed promising clinical outcome for ocular surface reconstruction in eyes with limbal dysfunction. The presence of oral mucosal epithelium was confirmed at 10 months postoperatively. However, reconstructed epithelium seems to have less barrier function than the corneal or conjunctival epithelium. Decreased barrier function may make the cornea more susceptible to infection. Further investigations are required in this aspect.
This PDF is available to Subscribers Only