Posters

Outcomes of cultivated oral mucosal epithelial transplantation (COMET) for ocular surface disorders and limbal stem cell deficiency (LSCD) in the United Kingdom

Poster Details

First Author: K.Elsawah EGYPT

Co Author(s):    S. Hamada   M. Elalfy   D. Lake              

Abstract Details

Purpose:

To investigate mid-term outcomes of cultivated oral mucosal epithelial transplantation (COMET) for the treatment of ocular surface disorders to determine efficacy and safety outcomes.

Setting:

Corneoplastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead,The United kingdom

Methods:

The clinical efficacy of COMET was assessed looking at outcomes in 14 eyes of 13 patients who received COMET for ocular surface disorders. A retrospective search was undertaken looking at patient notes from 2014 to 2017 collected from the Queen Victoria Hospital in East Grinstead. All 14 cases were defined as being totally limbal stem cell deficient (LSCD). Main outcomes measures: (1) ocular surface stability, defined as measuring a clear, fully epithelialised ocular surface, absent of epithelial defect, inflammation and neovascularisation. (2) pre and post-COMET visual acuity (VA) and  (3) Safety outcomes and reporting any complication.

Results:

total of 13 patients (14 eyes) were evaluated. Mean age was 46 years old. Mean follow up was 15ms with longest follow being 32ms. Primary aetiology underlying LSCD included aniridia (64%), chemical injury (22%) , SJS (7%) and keratoconjuctivitis (7%). Success of COMET achieved in all 14 cases at final examination. Following COMET 50% (n=7/14) of patients experienced varying degrees of epithelial defect. However, all cases self-resolved during follow-up. No significant improvements were observed in visual acuity following COMET. Only minor Complications included dry eyes in 14%, pain and photophobia (7%) and raised intra-ocular pressure (IOP) (7%).

Conclusions:

We conclude that COMET is a safe and successful treatment option for severe ocular surface disorders where options may have been exhausted..These results provide United Kingdom data on benchmarking for COMET procedure. This study highlights the need for an international register of patients undergoing COMET in order to measure international outcomes and ensure appropriate clinical guidelines for COMET are readily available. This study represents the largest UK based evaluation of ocular surface stability outcomes following COMET. Longer-term outcomes are needed for a more comprehensive analysis of ocular outcomes and graft survival.

Financial Disclosure:

None