Transplantation of human limbal epithelium cultivated on amniotic membrane for the treatment of severe ocular surface disorders

Jun Shimazaki, Masayo Aiba, Eiki Goto, Naoko Kato, Shigeto Shimmura, Kazuo Tsubota

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Abstract

Purpose: To study the short-term clinical results of transplanting of cultivated corneal/limbal epithelial cells on human amniotic membrane (AM) for limbal deficiency. Design: Noncomparative, retrospective interventional case series. Participants: 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. Intervention: Cultivated allo-limbal epithelium was transplanted onto the ocular surface of patients with severe limbal deficiency. Main Outcome Measures: 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.

Original languageEnglish
Pages (from-to)1285-1290
Number of pages6
JournalOphthalmology
Volume109
Issue number7
DOIs
Publication statusPublished - 2002
Externally publishedYes

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Amnion
Epithelium
Transplantation
Therapeutics
Eye Burns
Corneal Perforation
Benign Mucous Membrane Pemphigoid
Chemical Burns
Stevens-Johnson Syndrome
Corneal Epithelium
Tokyo
Keratitis
Ophthalmology
Basement Membrane
Visual Acuity

ASJC Scopus subject areas

  • Ophthalmology

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Transplantation of human limbal epithelium cultivated on amniotic membrane for the treatment of severe ocular surface disorders. / Shimazaki, Jun; Aiba, Masayo; Goto, Eiki; Kato, Naoko; Shimmura, Shigeto; Tsubota, Kazuo.

In: Ophthalmology, Vol. 109, No. 7, 2002, p. 1285-1290.

Research output: Contribution to journalArticle

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abstract = "Purpose: To study the short-term clinical results of transplanting of cultivated corneal/limbal epithelial cells on human amniotic membrane (AM) for limbal deficiency. Design: Noncomparative, retrospective interventional case series. Participants: 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. Intervention: Cultivated allo-limbal epithelium was transplanted onto the ocular surface of patients with severe limbal deficiency. Main Outcome Measures: 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.",
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