Alireza Baradaran-Rafii1, Siamak Delfazayebaher1, Nasser Aghdami2, Ehsan Taghiabadi3, Shahram Bamdad4, Danial Roshandel1. 1. Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Department of Regenerative Biomedicine at Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. Electronic address: nasser.aghdami@royaninstitute.org. 3. Department of Regenerative Biomedicine at Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. 4. Department of Ophthalmology, Poostchi Eye Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Abstract
PURPOSE: To evaluate the midterm outcomes of penetrating keratoplasty (PKP) after cultivated oral mucosal epithelial transplantation (COMET) in patients with bilateral total limbal stem cell deficiency (LSCD) due to chemical burn. METHODS: In this prospective interventional nonrandomized case series, optical PKP was performed in patients with severe stromal opacity after successful COMET. Main outcome measures were stability of the ocular surface, visual acuity improvement and corneal graft survival. RESULTS: Fourteen eyes of 14 patients with successful COMET were included. Time interval between PKP and COMET was 7.6 ± 1.3 months (6-9 months). Mean follow-up period was 28.2 ± 8 months (14-40 months, median 30 months). Epithelial healing was complete after 7 days in all eyes. Thirteen eyes had stable ocular surface without epithelial defect at final examination. The corneal surface had been covered by a transparent epithelium without significant neovascularization. Persistent epithelial defect developed in one eye 3 months after PKP which was considered as graft failure. Best-corrected visual acuity increased from 2.67 ± 0.08 LogMAR preoperatively to 0.64 ± 0.27 LogMAR after PKP (P < 0.001). Endothelial rejection occurred in four patients and was successfully managed by systemic and topical corticosteroids. Overall and rejection-free graft survival rates were 92.9 and 69.2%, respectively. CONCLUSION: PKP after COMET is a successful procedure which can be used to restore visual function in cases with bilateral total LSCD associated with severe stromal opacity due to chemical burns.
PURPOSE: To evaluate the midterm outcomes of penetrating keratoplasty (PKP) after cultivated oral mucosal epithelial transplantation (COMET) in patients with bilateral total limbal stem cell deficiency (LSCD) due to chemical burn. METHODS: In this prospective interventional nonrandomized case series, optical PKP was performed in patients with severe stromal opacity after successful COMET. Main outcome measures were stability of the ocular surface, visual acuity improvement and corneal graft survival. RESULTS: Fourteen eyes of 14 patients with successful COMET were included. Time interval between PKP and COMET was 7.6 ± 1.3 months (6-9 months). Mean follow-up period was 28.2 ± 8 months (14-40 months, median 30 months). Epithelial healing was complete after 7 days in all eyes. Thirteen eyes had stable ocular surface without epithelial defect at final examination. The corneal surface had been covered by a transparent epithelium without significant neovascularization. Persistent epithelial defect developed in one eye 3 months after PKP which was considered as graft failure. Best-corrected visual acuity increased from 2.67 ± 0.08 LogMAR preoperatively to 0.64 ± 0.27 LogMAR after PKP (P < 0.001). Endothelial rejection occurred in four patients and was successfully managed by systemic and topical corticosteroids. Overall and rejection-free graft survival rates were 92.9 and 69.2%, respectively. CONCLUSION: PKP after COMET is a successful procedure which can be used to restore visual function in cases with bilateral total LSCD associated with severe stromal opacity due to chemical burns.
Authors: Danial Roshandel; Medi Eslani; Alireza Baradaran-Rafii; Albert Y Cheung; Khaliq Kurji; Sayena Jabbehdari; Alejandra Maiz; Setareh Jalali; Ali R Djalilian; Edward J Holland Journal: Ocul Surf Date: 2018-06-20 Impact factor: 5.033
Authors: Yu Qin; Yixin Yu; Julia Fu; Xinyi Xie; Tao Wang; Maria A Woodward; Yannis M Paulus; Xinmai Yang; Xueding Wang Journal: Transl Vis Sci Technol Date: 2020-12-09 Impact factor: 3.283