Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction

Pinnita Prabhasawat,1 Pattama Ekpo,2 Mongkol Uiprasertkul,3 Suksri Chotikavanich,1 Nattaporn Tesavibul11Department of Ophthalmology, 2Department of Immunology, 3Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandPurpose: To investigate the clinical o...

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Autores principales:	Prabhasawat P, Ekpo P, Uiprasertkul M, Chotikavanich S, Tesavibul N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/517931159cce431da20525d1bf07b8f0
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spelling	oai:doaj.org-article:517931159cce431da20525d1bf07b8f02021-12-02T03:40:23ZEfficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction1177-54671177-5483https://doaj.org/article/517931159cce431da20525d1bf07b8f02012-09-01T00:00:00Zhttp://www.dovepress.com/efficacy-of-cultivated-corneal-epithelial-stem-cells-for-ocular-surfac-a10967https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Pinnita Prabhasawat,1 Pattama Ekpo,2 Mongkol Uiprasertkul,3 Suksri Chotikavanich,1 Nattaporn Tesavibul11Department of Ophthalmology, 2Department of Immunology, 3Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandPurpose: 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 &plusmn; 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 &plusmn; 13.5 months; range 6&ndash;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 &plusmn; 6.9 months (range, 12&ndash;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.Keywords: limbal deficiency, limbal transplantation, corneal epithelial stem-cell transplantation, cultivated corneal epithelial stem cellsPrabhasawat PEkpo PUiprasertkul MChotikavanich STesavibul NDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2012, Iss default, Pp 1483-1492 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Prabhasawat P Ekpo P Uiprasertkul M Chotikavanich S Tesavibul N Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
description	Pinnita Prabhasawat,1 Pattama Ekpo,2 Mongkol Uiprasertkul,3 Suksri Chotikavanich,1 Nattaporn Tesavibul11Department of Ophthalmology, 2Department of Immunology, 3Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, ThailandPurpose: 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 &plusmn; 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 &plusmn; 13.5 months; range 6&ndash;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 &plusmn; 6.9 months (range, 12&ndash;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.Keywords: limbal deficiency, limbal transplantation, corneal epithelial stem-cell transplantation, cultivated corneal epithelial stem cells
format	article
author	Prabhasawat P Ekpo P Uiprasertkul M Chotikavanich S Tesavibul N
author_facet	Prabhasawat P Ekpo P Uiprasertkul M Chotikavanich S Tesavibul N
author_sort	Prabhasawat P
title	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_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_sort	efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/517931159cce431da20525d1bf07b8f0
work_keys_str_mv	AT prabhasawatp efficacyofcultivatedcornealepithelialstemcellsforocularsurfacereconstruction AT ekpop efficacyofcultivatedcornealepithelialstemcellsforocularsurfacereconstruction AT uiprasertkulm efficacyofcultivatedcornealepithelialstemcellsforocularsurfacereconstruction AT chotikavanichs efficacyofcultivatedcornealepithelialstemcellsforocularsurfacereconstruction AT tesavibuln efficacyofcultivatedcornealepithelialstemcellsforocularsurfacereconstruction
_version_	1718401661924278272

Efficacy of cultivated corneal epithelial stem cells for ocular surface reconstruction

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