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Background: The loss of limbal stem cells owing to either corneal burn or inflammation leads to the repopulation of opaque skin over the raw surface of the cornea. It has been proposed that reconstitution of oral mucosal stem cells over this raw surface will mimic the limbal stem cells and restore vision. The efficacy and safety of applying a sheet of cultivated oral mucosal cells as an autologous graft for corneal replacement were evaluated.Case Presentation: The study was conducted during 2014-2015 and involved a total of six patients, of whom three had suffered a chemical burn and three had Stevens-Johnson Syndrome (SJS). Oral mucosal tissue was dissected from each patient, seeded onto irradiated J2 fibroblast feeder cells for 14 days, and analyzed for quality and safety 1 day before being transplanted onto the cornea of the affected eyes. After transplantation, topical antibiotic and anti-inflammatory eye drops were instilled four times daily, and the patients wore contact lenses. Subjects were clinically followed for visual acuities and adverse effects at 2, 4, and 6 weeks, 3 and 6 months, and 1 year post-transplantation. Data were presented descriptively. Visual acuities in patients improved at 2 weeks post-surgery. However, two patients with SJS had corneal ulcer at 2 weeks postoperatively. At the 1-year postoperative examination, the eyes of two patients were in good condition with decreased vascularization and epithelial defect.Conclusions: Cultivated oral mucosal epithelial sheet transplantation in limbal stem cell deficiency had a favorable efficacy. In this study, patients with chemical burn had more clinical benefit than those with SJS. Trial registration ClinicalTrials.gov: NCT02415218. Registered retrospectively 4 Apr 2015 ( https://clinicaltrials.gov/ct2/show/NCT02415218 ). [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacies of a single thermodynamic treatment system (LipiFlow®) and warm compresses used for 3 months in patients with a moderate severity of meibomian gland dysfunction (MGD). Methods: This prospective, randomized, controlled clinical study enrolled 28 patients (22 females, 6 males; mean age, 53.9 ± 14.8 years) diagnosed as having moderate MGD by plugging at the meibomian gland orifices between one-third and two-thirds of lid margins and at least one of the following: a Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire score of 6-12; a lipid layer thickness (LLT) score of 40-70 Interferometric Color Units; upper eyelid meiboscore of 1-2; and 3-6 expressible meibomian glands (EMGs) in the lower eyelid. Both eyes of each patient were randomized into study and control eyes. Study eyes were treated with a single, 12-minute LipiFlow® system, while control eyes received 5-minute warm compresses twice daily for 3 months. The dry eye symptoms, the number of EMGs, and LLTs were evaluated. Results: There were no significant differences in the dry eye symptoms, number of EMGs, and LLTs for both groups at baseline and at each follow-up. However, the total SPEED scores for the LipiFlow® group reduced significantly from baseline at each follow-up until 6 months. As to the warm compress group, the total SPEED scores reduced significantly from baseline at each follow-up until 3 months. Conclusion: The single LipiFlow® treatment and twice-daily warm compresses relieved the dry eye symptoms of patients with a moderate severity of MGD compared with their baseline symptoms, despite no statistical differences in the dry eye symptoms, number of EMGs, and LLTs of both treatments. [ABSTRACT FROM AUTHOR]

Objective: To determine two-year outcome of intrastromal corneal ring segment (ICRS) implantation in keratoconus in Thai patients Methods: A retrospective review of medical records of the patients underwent Ferrara-type ICRS implantation (single and two segments) at Siriraj Hospital between November 2013 and December 2017 was conducted. Clinical outcomes were assessed at 1 month, 6 months, 1 year, and 2 years postoperatively. Results: Of 9 eyes in 8 patients, the mean age of the patients was 24.6 ± 7.5 years. The mean follow-up time was 32.2 ± 9.4 months. Overall, the median visual acuity was significantly improved postoperatively (p value = 0.007). At 2 years, the uncorrected visual acuity (UCVA) improved from 1.00 logMAR to 0.56 logMAR, and the corrected distance visual acuity (CDVA) improved from 0.76 logMAR to 0.10 logMAR. Correspondingly, the median spherical equivalent refraction was significantly improved postoperatively from -7.38 D to -3.13 D (p < 0.001). Moreover, the median anterior corneal topographic data significantly changed between visits (p < 0.02). The Kmax decreased from 52.65 D to 46.65 D and the Kmean decreased from 48.10 D to 45.40 D at 2 years. Postoperative adverse effects were glare and halos (3 eyes), visually insignificant small white corneal deposits around the segments (2 eyes), extrusion of a ring segment needed removal with reversible to baseline vision (1 eye). Conclusion: This initial report in Thai patients showed that the ICRS implantation in keratoconus could improve the visual, refractive, and topographic parameters with stability at 2 years. However, appropriate case selection and surgical technique should be considered. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of preserved human amniotic membrane transplantation for reconstruction of the corneal surface diseases. Methods: Preserved human amniotic membrane transplantations were performed in 84 eyes of 78 patients for corneal surface reconstruction. The indications were limbal stem cell deficiency from Steven–Johnson syndrome, chemical burn and herpes keratitis (27 eyes), bullous keratopathy (26 eyes), persistent epithelial defect and dellen (17 eyes), band keratopathy (11 eyes), preparing for prosthesis (1 eye), corneal ulcer (1 eye) and acute chemical burn (1 eye). Results: Success was noted in 83.3% (70/84) eyes, partial success in 13.1% (11/84) eyes, and failure in 3.6% (3/84) eyes for an average follow-up of 10.5 months (3 – 29 months). No patient developed major immediate post-operative complications. Conclusion: Amniotic membrane transplantation can reduce inflammation, promote corneal epithelial healing, and decrease irritation in corneal surface problems. [ABSTRACT FROM AUTHOR]