Cultivated Limbal and Oral Mucosal Epithelial Transplantation in Severe Ocular Surface Disease
Article Sidebar
Abstract
Background: To evaluate and compare the clinical outcome and safety of Cultivated Limbal Epithelial Transplantation (CLET) and Cultivated Oral Mucosal Epithelial Transplantation (COMET) in severe ocular surface disease.
Methods: Retrospective literature review. Studies reporting CLET or COMET as treatment of ocular surface disorder were included in this review. All studies were level IV or higher published between 2002 and 2012. The outcomes evaluated in each study include transplantation success rate, improvement of visual acuity, and the safety covered post operative complications. No publication data restriction was used.
Results: Eight articles were reviewed. Steven-Johnson Syndrome (SJS) was found to be the most common cause of ocular surface disease in all studies. None of these studies compared CLET and COMET directly. All studies achieved success rate and 3-years survival rate of more than 50%. Visual acuity improvement ranged between 43.5-67.8%, while the mean duration unitl epithelization ranged between 13.7 days to 3 months. The most common complication was persistent epithelial defect (PED).
Conclusion: Both CLET and COMET offer a viable and safe alternative in ocular surface reconstruction, and thus may be considered as the management of the ocular surface disorder following SJS or chemical injury.
Â
Keywords: Cultivated limbal epithelium transplantation, cultivated oral mucosal epithelium transplantation, ocular surface disorder, ocular surface disease
Full text article
References
Kinoshita S, Koizumi N, Nakamura T. Transplantable cultivated mucosal epithelial sheet for ocular surface reconstruction. Exp Eye Res. 2004;78:483-91
Eslani M, Baradaran-Rafii A, Ahmad S. Cultivated limbal and oral mucosal epithelial transplantation. Semin Ophthalmol. 2012;27:80-93
Burman S, Sangwan V. Cultivated limbal stem cell transplantation for ocular surface reconstruction. Clin Ophthalmol. 2008;2:489-502
Basu S, Fernandez MM, Das S, Gaddipati S, Vemuganti GK, Sangwan VS. Clinical outcomes of xeno-free allogeneic cultivated limbal epithelial transplantation for bilateral limbal stem cell deficiency. Br J Ophthalmol. 2012;96:1504-9
Sangwan SS, Matalia HP, Vemuganti GK, Fatima A, Ifthekar G, Singh S, et al. Clinical outcome of autologous cultivated limbal epithelium transplantation. Indian J Ophthalmol. 2006;54:29-34
Shimazaki J, Higa K, Morito F, Dogru M, Kawakita T, Satake Y, et al. Factor influencing outcomes in cultivated limbal epithelial transplantation for chronic cicatrical ocular surface disorders. Am J Ophthalmol. 2007;143:945-53
Shimazaki J, Aiba M, Goto E, Kato N, Shimmura S, Tsubota K. Transplantation of human limbal epithelium cultivated on amniotic membrane for the treatment of severe ocular surface disorders. Ophthalmology. 2012;109:1285-90
Satake Y, Higa K, Tsubota K, Shimazaki J. Long-term outcome of cultivated oral mucosal epithelial sheet transplantation in treatment of total limbal stem cell deficiency. Ophthalmology. 2011;118:1524-30
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
Inatomi T, Nakamura T, Koizumi N, Sotozono C, Yokoi N, Kinoshita S. Midterm results on ocular surface reconstruction using cultivated autologus oral mucosal epithelial transplantation. Am J Ophthalmol. 2006;141:267- 75
Paukklin M, Steuhl KP, Meller D. Characterization of the corneal surface in limbal stem cell deficiency and after transplantation of cultivated limbal epithelium. Opthalmology. 2009;116:1048-56
Eslani M, Baradaran-Rafii A, Ahmad S. Cultivated limbal and oral mucosal epithelial transplantation. Semin Ophtalmol. 2012;27:80-93
Basu S, Ali H, Sangwan VS. Clinical outcomes of repeat autologous cultivated limbal epithelial transplantation for ocular surface burns. Am J Ophtalmol. 2012;153:643-50