title: Midterm results on ocular surface reconstruction using cultivated autologous oral mucosal epithelial transplantation.
abstract: OBJECTIVE
  To perform a midterm assessment of the integrity and reproducibility of cultivated autologous oral mucosal epithelial sheets, and to evaluate the clinical efficacy of their transplantation in ocular surface.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Cultivated autologous oral mucosal epithelial sheets were created using amniotic membrane and buccal mucosal epithelium from 12 patients with Stevens-Johnson syndrome, chemical and thermal injury, pseudo-ocular cicatricial pemphigoid, and idiopathic ocular surface disorder. They were transplanted onto 15 eyes from these patients who were then followed up for a mean of 20 months; with the longest follow-up being 34 months. We assessed their clinical outcomes with special reference to neovascularization.
  
  
  RESULTS
  Cultivated autologous oral mucosal epithelial sheets could be generated from all patients. On the second postoperative day, 14 of 15 sheets transplanted demonstrated total re-epithelialization on the cornea. During the follow-up, the ocular surface was stable and transparent without any major complications in 10 of 15 eyes (67%), and the transplanted epithelium survived for at least 34 months. There were five eyes (33%) with small but long-standing epithelial defects, three of these healed spontaneously, and two (13%) required reoperation. In 10 eyes, postoperative visual acuity was improved by more than 2 lines. All eyes manifested some peripheral corneal vascularization.
  
  
  CONCLUSIONS
  We established a successful tissue-engineering technique to generate cultivated autologous oral mucosal epithelial sheets and succeeded in reconstructing the ocular surface. We suggest that this surgical modality may be both safe and useful, especially in younger patients with the most severe ocular surface disorders.
authors.affiliation: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Inatomi
authors.forename: Takahiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Noriko
authors.initials: N
authors.lastname: Koizumi
authors.forename: Chie
authors.initials: C
authors.lastname: Sotozono
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yokoi
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000650:Amnion; D017690:Cell Transplantation; D002478:Cells, Cultured; D003316:Corneal Diseases / Q000150:complications / Q000601:surgery*; D004847:Epithelial Cells / Q000502:physiology / Q000637:transplantation*; D019573:Epithelium, Corneal / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000166:cytology*; D023822:Tissue Engineering; D014182:Transplantation, Autologous; D016896:Treatment Outcome