Autologous Cultivated Oral Mucosal Epithelial Sheet Can Be Used for Ocular Surface Reconstruction

Abstract

Abstract: : Purpose: We have successfully established a surgical system for cultivated oral epithelium transplantation for ocular surface reconstruction in rabbits using amniotic membrane (AM) as a carrier (IOVS 2002 abstract). The purpose of this study is to evaluate a new surgical system of autologous human cultivated oral mucosal epithelium transplantation in severe ocular surface diseases. Methods: In 3 eyes of 2 patients with severe chemical burns, oral mucosal biopsies (2x2 mm) were obtained 2 - 3 weeks prior to transplantation. The oral epithelial cells were cultivated for 2 - 3 weeks on a denuded AM carrier with 3T3 fibroblasts co-culture and air-lifting. The conjunctivalized corneal surfaces of these patients were surgically reconstructed by transplanting autologous oral epithelial cells cultivated on AM. Results: In all 3 eyes, the entire corneal surface, on which cultivated oral epithelium had been placed, was free from epithelial defects 48 hours after surgery, indicating complete survival of the transplanted oral epithelium. At 7 days after transplantation, the area covered by epithelium had expanded outward and was partially in contact with the adjacent conjunctival epithelium. Visual acuity improved in all eyes during the follow-up period (6 months and 4 months, respectively). Conclusions: Autologous human cultivated oral epithelial transplantation using denuded AM as a carrier can be used for severe ocular surface diseases.

Keywords: cornea: clinical science • cornea: epithelium • clinical (human) or epidemiologic studies: tre