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Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction

PURPOSE: To investigate the clinical outcomes of cultivated corneal limbal epithelial transplantation (CLET) using human amniotic membrane for corneal limbal stem-cell deficiency. METHODS: Prospective, noncomparative case series. Eighteen patients (19 eyes) with severe ocular surface diseases were c...

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Autores principales: Prabhasawat, Pinnita, Ekpo, Pattama, Uiprasertkul, Mongkol, Chotikavanich, Suksri, Tesavibul, Nattaporn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460717/
https://www.ncbi.nlm.nih.gov/pubmed/23055668
http://dx.doi.org/10.2147/OPTH.S33951
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author Prabhasawat, Pinnita
Ekpo, Pattama
Uiprasertkul, Mongkol
Chotikavanich, Suksri
Tesavibul, Nattaporn
author_facet Prabhasawat, Pinnita
Ekpo, Pattama
Uiprasertkul, Mongkol
Chotikavanich, Suksri
Tesavibul, Nattaporn
author_sort Prabhasawat, Pinnita
collection PubMed
description PURPOSE: To investigate the clinical outcomes of cultivated corneal limbal epithelial transplantation (CLET) using human amniotic membrane for corneal limbal stem-cell deficiency. METHODS: Prospective, noncomparative case series. Eighteen patients (19 eyes) with severe ocular surface diseases were chosen to undergo CLET using human amniotic membrane. Twelve eyes received auto-CLET, and seven eyes received allo-CLET. Clinical outcomes of corneal surface epithelialization, conjunctivalization, inflammation, visual acuity, graft status, and complications were observed. RESULTS: Corneal epithelium cultivated on amniotic membrane (two to four layers) was positive for molecular markers p63, ABCG2, CK3, and CK12. The mean patient age was 44.7 ± 15.2 years. A successful clinical outcome, defined as corneal epithelialization without central conjunctivalization or severe inflammation, was obtained in 14 (73.7%) of 19 eyes (mean follow-up 26.1 ± 13.5 months; range 6–47). A histopathologic success, defined as absence of goblet cells at the central cornea, was achieved in 12 (63.2%) eyes. Clinical failures occurred in five (26.3%) of 19 eyes, and histopathologic failures occurred in seven (36.8%) of 19 eyes. Survival analysis at 1 year showed that the clinical success rate was 77.9% and the pathological success rate was 72.3%. Fourteen of 19 (73.7%) eyes had visual acuity improvements after CLET. Six cases underwent penetrating keratoplasty; five of these grafts remained clear after 20.4 ± 6.9 months (range, 12–31) of follow-up. Complications included infectious keratitis (three cases) and recurrent symblepharon (one case). All complicated cases had lid abnormalities. Factors affecting the final clinical outcomes were lid abnormalities, abnormal corneal stromal beds, and complications. CONCLUSION: CLET can successfully restore ocular surface damage in most cases with corneal limbal stem cell deficiency.
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spelling pubmed-34607172012-10-09 Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction Prabhasawat, Pinnita Ekpo, Pattama Uiprasertkul, Mongkol Chotikavanich, Suksri Tesavibul, Nattaporn Clin Ophthalmol Original Research PURPOSE: To investigate the clinical outcomes of cultivated corneal limbal epithelial transplantation (CLET) using human amniotic membrane for corneal limbal stem-cell deficiency. METHODS: Prospective, noncomparative case series. Eighteen patients (19 eyes) with severe ocular surface diseases were chosen to undergo CLET using human amniotic membrane. Twelve eyes received auto-CLET, and seven eyes received allo-CLET. Clinical outcomes of corneal surface epithelialization, conjunctivalization, inflammation, visual acuity, graft status, and complications were observed. RESULTS: Corneal epithelium cultivated on amniotic membrane (two to four layers) was positive for molecular markers p63, ABCG2, CK3, and CK12. The mean patient age was 44.7 ± 15.2 years. A successful clinical outcome, defined as corneal epithelialization without central conjunctivalization or severe inflammation, was obtained in 14 (73.7%) of 19 eyes (mean follow-up 26.1 ± 13.5 months; range 6–47). A histopathologic success, defined as absence of goblet cells at the central cornea, was achieved in 12 (63.2%) eyes. Clinical failures occurred in five (26.3%) of 19 eyes, and histopathologic failures occurred in seven (36.8%) of 19 eyes. Survival analysis at 1 year showed that the clinical success rate was 77.9% and the pathological success rate was 72.3%. Fourteen of 19 (73.7%) eyes had visual acuity improvements after CLET. Six cases underwent penetrating keratoplasty; five of these grafts remained clear after 20.4 ± 6.9 months (range, 12–31) of follow-up. Complications included infectious keratitis (three cases) and recurrent symblepharon (one case). All complicated cases had lid abnormalities. Factors affecting the final clinical outcomes were lid abnormalities, abnormal corneal stromal beds, and complications. CONCLUSION: CLET can successfully restore ocular surface damage in most cases with corneal limbal stem cell deficiency. Dove Medical Press 2012 2012-09-11 /pmc/articles/PMC3460717/ /pubmed/23055668 http://dx.doi.org/10.2147/OPTH.S33951 Text en © 2012 Prabhasawat et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Original Research
Prabhasawat, Pinnita
Ekpo, Pattama
Uiprasertkul, Mongkol
Chotikavanich, Suksri
Tesavibul, Nattaporn
Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
title Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
title_full Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
title_fullStr Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
title_full_unstemmed Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
title_short Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
title_sort efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460717/
https://www.ncbi.nlm.nih.gov/pubmed/23055668
http://dx.doi.org/10.2147/OPTH.S33951
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