Transplantation of human limbal epithelium cultivated on amniotic membrane for the treatment of severe ocular surface disorders.
OBJECTIVE
To study the short-term clinical results of transplanting of cultivated corneal/limbal epithelial cells on human amniotic membrane (AM) for limbal deficiency.


METHODS
Noncomparative, retrospective interventional case series.


METHODS
Thirteen eyes of 13 patients with severe limbal deficiency (Stevens-Johnson syndrome in eight eyes, ocular cicatricial pemphigoid in three eyes, and chemical burns in two eyes) were treated at the department of Ophthalmology, Tokyo Dental College, Japan.


METHODS
Cultivated allo-limbal epithelium was transplanted onto the ocular surface of patients with severe limbal deficiency.


METHODS
Ocular surface reconstruction with corneal epithelialization, changes in visual acuity, and postoperative complications were studied. Histologic examinations were also performed on cultivated epithelium.


RESULTS
Cultivated corneal epithelium on AM formed two to three layers with the formation of basement membrane-like structures. After the surgery, the epithelium regenerated and covered the ocular surface in eight eyes (61.5%). However, three of the eight eyes developed partial conjunctival invasion, and two eyes later developed epithelial defects. At last examination, corneal epithelialization was achieved in six eyes (46.2%). Five eyes had conjunctivalization, one eye had dermal epithelialization, and one eye was not epithelialized. Complications were corneal perforation in four eyes and infectious keratitis in two eyes.


CONCLUSIONS
This study demonstrates that the success rate for transplanting cultivated allo-limbal epithelium on the AM is not different from the conventional limbal and AM transplantation for the treatment of severe limbal stem cell dysfunction.
Shimazaki
Jun
J
Department of Ophthalmology, Tokyo Dental College, 5-11-13 Sugano, Ichikawa-shi, Chiba 272-8513, Japan.
Aiba
Masayo
M
Goto
Eiki
E
Kato
Naoko
N
Shimmura
Shigeto
S
Tsubota
Kazuo
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000650:Amnion; D018929:Cell Culture Techniques / Q000379:methods; D017690:Cell Transplantation; D002478:Cells, Cultured; D003316:Corneal Diseases / Q000601:surgery*; D019573:Epithelium, Corneal / Q000166:cytology / Q000637:transplantation*; D005260:Female; D006085:Graft Survival; D006801:Humans; D016850:Limbus Corneae / Q000166:cytology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000166:cytology; D016896:Treatment Outcome; D014792:Visual Acuity