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

Session Details

Session Title: Presented Poster Session: Cornea: Surgical

Venue: Poster Village: Pod 3

First Author: : R.Tweddell UK

Co Author(s): :    S. Hamada                       

Abstract Details

Purpose:

Retrospective audit study. 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:

A retrospective search was undertaken looking at patient notes from 2014 to 2018 collected from the Queen Victoria Hospital in East Grinstead.

Methods:

The clinical efficacy of COMET was assessed looking at outcomes in 14 eyes of 13 patients who received COMET for ocular surface disorders. 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 epithelialized ocular surface, absent of epithelial defect, inflammation and neovascularisation. (2) pre and post-COMET visual acuity (VA) and (3) Safety outcomes, looking at complications.

Results:

Mean patient age was 47 years old. Mean follow up was 15 months with longest follow up being 32 months. Primary aeitolgy underlying LSCD included aniridia (64%), chemical injury (22%) , SJS (7%) and keratoconjuctivitis (7%). Success of COMET was achieved in all 14 cases (100%) at final examination. No significant measurable improvements were observed in VA following COMET. Complications were minor and included increased sensation of dry eyes in 14%, pain and photophobia (7%) as well as raised intra-ocular pressure (IOP) (7%).

Conclusions:

The results of this study demonstrate success of COMET in achieving ocular surface stability for severe ocular surface disorders (OSD). These results provide UK (UK) data on benchmarking for COMET procedure. We conclude that COMET is a safe and successful treatment option for severe ocular surface failure where options may have been exhausted. 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

Financial Disclosure:

None