Ex-vivo cultured autologous limbal stem cell transplantation for different ocular surface problems

Session Details

Session Title: Cornea: Surgical II

Session Date/Time: Tuesday 08/09/2015 | 14:00-16:00

Paper Time: 15:26

Venue: Room 11

First Author: : I.Durak TURKEY

Co Author(s): :    M. Gurdal   Z. Ozbek   O. Barut selver   H. Kilinc           

Abstract Details

Purpose:

To report and discuss the results of ex-vivo cultured limbal stem cell transplantation (CLSCT) in patients with different etiologies of limbal stem cell deficiency (LSCD).

Setting:

Department of Ophthalmology, Dokuz Eylul University School of Medicine, Izmir, Turkey.

Methods:

Patients who had undergone CLSCT between 2009 and 2014 were evaluated with regard to age, sex, etiology, visual acuity, fluorescein staining, corneal vascularization at presentation and the last visit. 1x1 mm superior limbal biopsy was performed from healthy eyes or better eyes of bilateral patients and expanded on human amniotic membrane for 14 days. 4X4 mm oral mucosal biopsy was performed in very severe bilateral patients for explant culture. Secondary or tertiary passages of explant were performed in selected cases. After removal of symblepharon and pannus, superficial keratectomy was performed and CLSCs on hAMs were transplanted.

Results:

23 eyes of 23 patients (14 males and 9 females) were included. Mean age was 37.7+19.3 years . Fourteen patients had alkali burns, 3 patients had multiple pterigium surgery, 2 patients had acid burns, 2 had SJS, 1 patient had severe explosive trauma and 1 had severe atopic keratoconjunctivitis. LSCD was unilateral in twenty patients and bilateral in 3 patients. Oral mucosa was used as explant culture source in 2 patients. Preoperative visual acuity was 2.16 logMAR (range: 3,1- 0.4). Mean follow-up after CLSCT was 23.3+25.1 months. Visual acuity at the last follow-up was 1.8 logMAR. No infection was noted. Corneal vascularization, status of the epithelium and fluorescein staining of the ocular surface was significantly better in 20 eyes.

Conclusions:

CLSCT is a safe and promising surgical procedure for severe limbal stem cell deficiency for ocular surface reconstruction with good visual results.

Financial Interest:

NONE