The Effect of In Vivo Grown Corneal Epithelium Transplantation on Persistent Epithelial Defects with Limbal Stem Cell Deficiency.
10.3346/jkms.2008.23.3.502
- Author:
Jee Taek KIM
1
;
Yeoun Sook CHUN
;
Kye Young SONG
;
Jae Chan KIM
Author Information
1. Department of Ophthalmology, College of Medicine, Yongsan Hospital Chung-Ang University, Seoul, Korea. jck50ey@kornet.net
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Amnion;
Epithelium, Corneal;
Limbus Corneae;
Tissue Expansion
- MeSH:
Adult;
Cell Culture Techniques;
Cells, Cultured;
Corneal Diseases/etiology/pathology/*surgery;
Corneal Transplantation/*methods;
Epithelial Cells/cytology/*transplantation;
Epithelium, Corneal/cytology/*transplantation;
Eye Burns/complications;
Humans;
Limbus Corneae/*pathology;
Male;
Middle Aged;
Stem Cells/*pathology;
Stevens-Johnson Syndrome/complications
- From:Journal of Korean Medical Science
2008;23(3):502-508
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report our experience with corneal epithelium, grown in vivo, transplantation in three patients with persistent epithelial defect (PED). The three patients had ocular surface disease unresponsive to standard treatments and were therefore chosen for transplantation. They underwent transplantation of epithelial sheets, grown in vivo, to the most affected eye. In vivo cultivation was carried out in the cornea of a living related donor. After epithelialization was completed, the epithelium grown on an amniotic membrane was harvested gently; it was then transplanted into the patient's eye after debridement of fibrovascular tissue. The cultivated epithelium was completely epithelialized by 2 weeks; it was well-differentiated with well-formed hemidesmosome. On immunohistochemical staining, p63, connexin 43, and Integrin beta4 were expressed in the cells on the epithelial sheet. The PED was covered completely and maintained for 4 weeks in all cases. However, corneal erosion recurred after 5 weeks in two cases. This novel technique demonstrates the corneal epithelial cells can be expanded in vivo successfully on denuded amniotic membrane of a healthy cornea and harvested safely. A corneal epithelial sheet, grown in vivo, can be transplanted to treat eye with a severe ocular surface disease, such as total limbal deficiency.