OPHTHALMOLOGY / CLINICAL RESEARCH
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Oral epithelial cells were recently shown to be able to differentiate into corneal epithelium, and the efficacy of cultured autologous oral mucosal epithelial cells (CAOMEC) has been suggested by the presence of epithelium replacement. Therefore, the aim of this study was to evaluate the treatment outcome in limbal stem cell deficiency (LSCD) by adding CAOMEC to regular amniotic membrane (AM) treatment.

Material and methods:
Eyes with LSCD were randomized to two groups to undergo either autologous oral mucosal epithelial cell sheet (CAOMECS) combined with AM transplantation (A group) or AM transplantation alone (B group). Clinical outcome measures were corneal epithelium healing, best corrected visual acuity, symblepharon, corneal transparency, corneal neovascularization and ocular surface inflammation.

Results:
The normal corneal epithelialization rate in group A (73.33%) was higher than that in group B (35.48%), and the average healing time was shorter (3.45 ±2.12 weeks vs. 4.64 ±1.63 weeks). The symblepharon in the above two groups was improved in the first 3 months after surgery, but after 6 months, part of the B group had recurrence. In improving corneal transparency, group A has obvious advantages. Corneal neovascularization (CNV) was improved to some extent in the first 3 months after surgery, but group A (1.47 ±0.64) was better than group B (1.94 ±0.85) after 6 months. Both groups can improve the inflammatory state to some extent.

Conclusions:
The transplantation of CAOMECS offers a viable and safe alternative in the reconstruction of a stable ocular surface. The effect is better than that of traditional AM transplantation, mainly in promoting corneal epithelialization, improving ocular surface structure, and reducing fiber and vascular infiltration.

 
REFERENCES (25)
1.
Kinoshita S, Adachi W, Sotozono C, et al. Characteristics of the human ocular surface epithelium. Prog Retin Eye Res 2001; 20: 639-73.
 
2.
Dua HS, Azuara-Blanco A. Limbal stem cells of the corneal epithelium. Surv Ophthalmol 2000; 44: 415-25.
 
3.
Prabhasawat P. Corneal limbal stem cells. Siriraj Med J 2006; 58: 728-9.
 
4.
Kenyon KR, Tseng SC. Limbal autograft transplantation for ocular surface disorders. Ophthalmology 1989; 96: 709-22; discussion 22-3.
 
5.
Solomon A, Ellies P, Anderson DF, et al. Long-term outcome of keratolimbal allograft with or without penetrating keratoplasty for total limbal stem cell deficiency. Ophthalmology 2002; 109: 1159-66.
 
6.
Alfonso EC. Treatment of severe ocular-surface disorders with corneal epithelial stem cell transplantation. Arch Ophthalmol 2000; 118: 123-4.
 
7.
Mikhailova A, Ilmarinen T, Ratnayake A, et al. Human pluripotent stem cell-derived limbal epithelial stem cells on bioengineered matrices for corneal reconstruction. Exp Eye Res 2016; 146: 26-34.
 
8.
Pietronave S, Prat M. Advances and applications of induced pluripotent stem cells. Can J Physiol Pharmacol 2012; 90: 317-25.
 
9.
Sotozono C, Inatomi T, Nakamura T, et al. Cultivated oral mucosal epithelial transplantation for persistent epithelial defect in severe ocular surface diseases with acute inflammatory activity. Acta Ophthalmol 2014; 92: e447-53.
 
10.
Nishida K, Yamato M, Hayashida Y, et al. Functional bioengineered corneal epithelial sheet grafts from corneal stem cells expanded ex vivo on a temperature-responsive cell culture surface. Transplantation 2004; 77: 379-85.
 
11.
Hayashida Y, Nishida K, Yamato M, et al. Ocular surface reconstruction using autologous rabbit oral mucosal epithelial sheets fabricated ex vivo on a temperature-responsive culture surface. Invest Ophthalmol Vis Sci 2005; 46: 1632-9.
 
12.
Dua HS, King AJ, Joseph A. A new classification of ocular surface burns. Br J Ophthalmol 2001; 85: 1379-83.
 
13.
Prabhasawat P, Ekpo P, Uiprasertkul M, et al. Long-term result of autologous cultivated oral mucosal epithelial transplantation for severe ocular surface disease. Cell Tissue Bank 2016; 17: 491-503.
 
14.
Panda A, Jain M, Vanathi M, Velpandian T, Khokhar S, Dada T. Topical autologous platelet-rich plasma eyedrops for acute corneal chemical injury. Cornea 2012; 31: 989-93.
 
15.
Kheirkhah A, Blanco G, Casas V, Hayashida Y, Raju VK, Tseng SC. Surgical strategies for fornix reconstruction based on symblepharon severity. Am J Ophthalmol 2008; 146: 266-75.
 
16.
Shore JW, Foster CS, Westfall CT, Rubin PA. Results of buccal mucosal grafting for patients with medically controlled ocular cicatricial pemphigoid. Ophthalmology 1992; 99: 383-95.
 
17.
Hata K, Kagami H, Ueda M, Torii S, Matsuyama M. The characteristics of cultured mucosal cell sheet as a material for grafting; comparison with cultured epidermal cell sheet. Ann Plast Surg 1995; 34: 530-8.
 
18.
Ueda M, Hata K, Horie K, Torii S. The potential of oral mucosal cells for cultured epithelium: a preliminary report. Ann Plast Surg 1995; 35: 498-504.
 
19.
Obokata H, Yamato M, Yang J, Nishida K, Tsuneda S, Okano T. Subcutaneous transplantation of autologous oral mucosal epithelial cell sheets fabricated on temperature-responsive culture dishes. J Biomed Mater Res A 2008; 86: 1088-96.
 
20.
Hirayama M, Satake Y, Higa K, Yamaguchi T, Shimazaki J. Transplantation of cultivated oral mucosal epithelium prepared in fibrin-coated culture dishes. Invest Ophthalmol Vis Sci 2012; 53: 1602-9.
 
21.
Sotozono C, Inatomi T, Nakamura T, et al. Visual improvement after cultivated oral mucosal epithelial transplantation. Ophthalmology 2013; 120: 193-200.
 
22.
Chen P, Zhou Q, Wang J, et al. Characterization of the corneal surface in limbal stem cell deficiency and after transplantation of cultured allogeneic limbal epithelial cells. Graefes Arch Clin Exp Ophthalmol 2016; 254: 1765-77.
 
23.
Utheim TP, Utheim OA, Khan QE, Sehic A. Culture of oral mucosal epithelial cells for the purpose of treating limbal stem cell deficiency. J Funct Biomater 2016; 7: 5.
 
24.
Kilic K, Konya D, Kurtkaya O, Sav A, Pamir MN, Kilic T. Inhibition of angiogenesis induced by cerebral arteriovenous malformations using gamma knife irradiation. J Neurosurg 2007; 106: 463-9.
 
25.
Utheim TP. Concise review: transplantation of cultured oral mucosal epithelial cells for treating limbal stem cell deficiency-current status and future perspectives. Stem Cells 2015; 33: 1685-95.
 
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