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Cultivated oral mucosal epithelial transplantation for persistent epithelial defect in severe ocular surface diseases with acute inflammatory activity.
- Source :
-
Acta ophthalmologica [Acta Ophthalmol] 2014 Sep; Vol. 92 (6), pp. e447-53. Date of Electronic Publication: 2014 May 19. - Publication Year :
- 2014
-
Abstract
- Purpose: To assess the clinical efficacy of cultivated oral mucosal epithelial transplantation (COMET) for the treatment of persistent epithelial defect (PED).<br />Methods: We treated 10 eyes of nine patients with PED (Stevens-Johnson syndrome: three eyes; thermal/chemical injury: five eyes; ocular cicatricial pemphigoid: two eyes) with COMET at Kyoto Prefectural University of Medicine, Kyoto, Japan from 2002 to 2008.<br />Results: Preoperatively, PED existed on over more than 50% of the corneal surface in seven eyes. Severe ocular surface inflammation with fibrovascular tissue surrounded the PED in all 10 eyes. At 24-weeks postoperative, PED had improved in all cases except 1 in which the patient was unable to return to the hospital (95% CI, 55.5-99.7; Wilcoxon signed-rank test, p = 0.0078). The preoperative median of logarithmic minimum angle of resolution was 1.85 (range 0.15-2.70), and 1.85, 1.85, and 1.52 at the 4th, 12th, and 24th postoperative week, respectively. The mean total preoperative ocular surface grading score was 7.0 (range 4-17). At 4 and 12 weeks postoperative, the total ocular surface grading score had improved significantly (p = 0.0020, p = 0.0078), and at 24 weeks postoperative, it was 3.0 (range 2-12, p = 0.0234). During the follow-up period (median 23.3 months, range 5.6-39.7 months), no recurrence of PED was observed in any eye, and long-term ocular surface stability was obtained.<br />Conclusion: COMET enabled complete epithelialization of PED and stabilization of the ocular surface in patients with severe ocular surface disease, thus preventing end-stage cicatrization and vision loss at a later stage.<br /> (© 2014 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.)
- Subjects :
- Acute Disease
Adult
Aged
Aged, 80 and over
Burns, Chemical pathology
Cell Transplantation
Cells, Cultured
Child
Corneal Injuries pathology
Eye Burns pathology
Female
Humans
Male
Middle Aged
Pemphigoid, Benign Mucous Membrane pathology
Re-Epithelialization
Stevens-Johnson Syndrome pathology
Visual Acuity
Burns, Chemical surgery
Corneal Injuries surgery
Epithelial Cells transplantation
Eye Burns chemically induced
Mouth Mucosa cytology
Pemphigoid, Benign Mucous Membrane surgery
Stevens-Johnson Syndrome surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1755-3768
- Volume :
- 92
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Acta ophthalmologica
- Publication Type :
- Academic Journal
- Accession number :
- 24835597
- Full Text :
- https://doi.org/10.1111/aos.12397