Abstract
Purpose :
Autologous cultivated corneal epithelium (Nepic®, J-TEC, Aichi) transplantation, which will be included in the Japanese National Health Insurance in June 2020, is attracting attention as a novel therapeutic approach for limbal stem cell deficiency (LSCD). The purpose of this study was to report the postoperative results of five cases in which autologous cultivated corneal epithelium transplantation was performed.
Methods :
Between May 2021 and March 2023, a retrospective study was conducted on five cases treated with autologous cultivated corneal epithelial transplantation for LSCD at Hiroshima University Hospital, Department of Ophthalmology. The study focused on patient demographics and postoperative courses.
Results :
The cohort consisted of five patients (four males and one female) with a mean age of 55.8 ± 7.8 years at the time of surgery. Causes of LSCD included thermal/chemical injury (three cases) and allergy (two cases). In three cases the limbus was harvested from the superior side, in the remaining two cases with a history of limbal transplantation or trabeculectomy the limbus was harvested from the inferior side. All patients underwent autologous cultivated corneal epithelial transplantation (Nepic®) approximately one month after limbal extraction. Intraoperative complications included central flap breakage in one case. Partial detachment of the transplanted epithelium occurred within two weeks of surgery in all cases, but re-epithelialization was achieved within three months in four patients. The remaining patient, who experienced prolonged epithelial defects, switched from betamethasone phosphate eye drops to fluorometholone and used a soft contact lens for an extended period, resulting in re-epithelialization at five months. Three of the five cases maintained high transparency in the epithelium-covered pupil region at two years postoperatively. One case underwent deep lamellar keratoplasty one year and eight months after surgery with rapid re-epithelialization.
Conclusions :
Autologous cultivated corneal epithelial transplantation (Nepic®) for LSCD seems to have promising results in the short and medium term.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.