Treatment of limbal stem cell deficiency with autologous cultivated oral mucosal epithelial transplantation

Abstract Background: To evaluate the feasibility of autologous cultivated oral mucosal epithelial transplantation (COMET) for the treatment of limbal stem cell deficiency (LSCD). Methods: Seven eyes from seven different patients with monocular LSCD were included in this study. Autologous oral mucosal epithelial cells were fabricated on ex vivo using amniotic membranes as a substrate. Clinical efficacy was evaluated by the coefficient of best-corrected visual acuity (BCVA). Clinical formation of the conjunctiva and symblepharon was evaluated and graded on a scale from 0 to 3. Clinical safety was evaluated by the presence of persistent epithelial defects, infection, and ocular hypertension. Results: Autologous COMET was successfully performed in all seven patients. The mean follow-up period was 10.7 months, during which time the postoperative formation of the conjunctiva and symblepharon was inhibited. BCVA was improved more than two lines in six eyes (86%) during the follow-up period. Complete reepithelialization of the corneal surfaces occurred in all treated eyes. No persistent epithelial defects, corneal infection, or postoperative ocular hypertension were observed. Conclusions: Autologous COMET offers a viable and safe alternative for the reconstruction of a stable ocular surface and improves vision in patients with LSCD.