title: Ocular surface reconstruction by cultivated epithelial sheet transplantation.
abstract: Recent advances in ocular surface reconstruction for patients with severe ocular surface diseases have significantly improved the prognosis of patients with vision-impairing corneal abnormalities. The history of cultivated epithelial sheet transplantation is short, and debate on the current approaches for these procedures is continuing. Limbal stem cell transplantation, including conjunctivolimbal autograft and keratolimbal allograft, has brought opportunities for vision improvement. In addition, the use of cultivated limbal epithelial transplantation from both allogeneic and autologous sources has provided further options for immediate postoperative epithelialization of the corneal surface. Finally, cultivated oral mucosal epithelial transplantation, which allows autologous transplantation for patients with bilateral limbal stem cell deficiency, has provided the best overall midterm and long-term results. Its biggest advantages are the absence of rejection reactions and the reduction of postoperative complications associated with steroid therapy. However, a solitary surgical approach is not sufficient for obtaining a good clinical outcome. To maximize the possibility of success using these procedures, it is important to preoperatively enhance aggressive treatment of the ocular surface, especially with factors that facilitate moisture retention. In this review article, we also discuss our clinical experience in relation to these surgical procedures.
authors.affiliation: *Department of Ophthalmology, Tokyo Dental College, Chiba, Japan; and †Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Satake
authors.forename: Takefumi
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hirayama
authors.forename: Kazunari
authors.initials: K
authors.lastname: Higa
authors.forename: Seika
authors.initials: S
authors.lastname: Shimazaki-Den
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawakita
authors.forename: Motoko
authors.initials: M
authors.lastname: Kawashima
authors.forename: Shigeto
authors.initials: S
authors.lastname: Shimmura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
mesh_terms: D017690:Cell Transplantation; D002478:Cells, Cultured; D003316:Corneal Diseases / Q000601:surgery*; D004847:Epithelial Cells / Q000637:transplantation*; D019573:Epithelium, Corneal / Q000637:transplantation*; D006801:Humans; D007223:Infant; D016850:Limbus Corneae / Q000166:cytology*; D019651:Plastic Surgery Procedures; D033581:Stem Cell Transplantation