Allogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative Study
Abstract Introduction This study compared the clinical outcomes of allogenic cultured limbal epithelial transplantation (ACLET) and cultivated oral mucosal epithelial transplantation (COMET) in the management of limbal stem cell deficiency (LSCD). Methods Forty-one COMET procedures in 40 eyes and 69...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2025-01-01
|
| Series: | Ophthalmology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40123-024-01083-x |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832585999304097792 |
|---|---|
| author | Mohamed Elalfy Kareem Elsawah Sundas Maqsood Nigel Jordan Mansour Hassan Ahmed Zaki Zisis Gatzioufas Samer Hamada Damian Lake |
| author_facet | Mohamed Elalfy Kareem Elsawah Sundas Maqsood Nigel Jordan Mansour Hassan Ahmed Zaki Zisis Gatzioufas Samer Hamada Damian Lake |
| author_sort | Mohamed Elalfy |
| collection | DOAJ |
| description | Abstract Introduction This study compared the clinical outcomes of allogenic cultured limbal epithelial transplantation (ACLET) and cultivated oral mucosal epithelial transplantation (COMET) in the management of limbal stem cell deficiency (LSCD). Methods Forty-one COMET procedures in 40 eyes and 69 ACLET procedures in 54 eyes were performed in the Corneoplastic Unit of Queen Victoria Hospital, East Grinstead. Data were examined for demographics, indications, ocular surface stability, absence of epithelial defect, ocular surface inflammation, visual outcomes, and intra- and postoperative complications. Results Kaplan–Meier analysis showed that patients in the ACLET group with longer follow-up had a significantly higher graft survival rate (81.7%, n = 56) than the COMET group (60.7%, n = 25) and the difference was statistically significant (p = 0.01). In the COMET group, there was no statistically significant improvement in the visual acuity (VA) while in the ACLET group there was statistically significant improvement in the final VA. Elevated intraocular pressure (IOP) developed in 9 eyes (22.0%) in the COMET group and in 18 eyes (26.1%) in the ACLET group; infection developed in 4 eyes (9.8%) in the COMET group and in 10 eyes (14.5%) in the ACLET group; and perforation or melting happened in 4 eyes (9.8%) in the COMET group and in 1 eye (1.4%) in the ACLET group. Postoperative immunosuppression complications were noted in 9 eyes (13.0%) in the ACLET group. No graft rejection was observed in either group. Conclusion Both ACLET and COMET are effective therapeutic procedures for managing advanced and bilateral cases of LSCD. Although COMET has lower graft survival rate than ACLET, it does not mandate systemic immunosuppression therapy to protect against potential graft rejection. |
| format | Article |
| id | doaj-art-8434b66d4a254430bc8494b373c90029 |
| institution | Kabale University |
| issn | 2193-8245 2193-6528 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Ophthalmology and Therapy |
| spelling | doaj-art-8434b66d4a254430bc8494b373c900292025-01-26T12:18:43ZengAdis, Springer HealthcareOphthalmology and Therapy2193-82452193-65282025-01-0114241343210.1007/s40123-024-01083-xAllogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative StudyMohamed Elalfy0Kareem Elsawah1Sundas Maqsood2Nigel Jordan3Mansour Hassan4Ahmed Zaki5Zisis Gatzioufas6Samer Hamada7Damian Lake8Corneoplastic Unit and Eye Bank, Queen Victoria Hospital NHS Foundation TrustCornea Unit, Research Institute of OphthalmologyDepartment of Ophthalmology, Maidstone and Tunbridge Wells NHS TrustCorneoplastic Unit and Eye Bank, Queen Victoria Hospital NHS Foundation TrustDepartment of Ophthalmology, Beni Suef UniversityCornea Unit, Research Institute of OphthalmologyDepartment of Ophthalmology, University of BaselCorneoplastic Unit and Eye Bank, Queen Victoria Hospital NHS Foundation TrustCorneoplastic Unit and Eye Bank, Queen Victoria Hospital NHS Foundation TrustAbstract Introduction This study compared the clinical outcomes of allogenic cultured limbal epithelial transplantation (ACLET) and cultivated oral mucosal epithelial transplantation (COMET) in the management of limbal stem cell deficiency (LSCD). Methods Forty-one COMET procedures in 40 eyes and 69 ACLET procedures in 54 eyes were performed in the Corneoplastic Unit of Queen Victoria Hospital, East Grinstead. Data were examined for demographics, indications, ocular surface stability, absence of epithelial defect, ocular surface inflammation, visual outcomes, and intra- and postoperative complications. Results Kaplan–Meier analysis showed that patients in the ACLET group with longer follow-up had a significantly higher graft survival rate (81.7%, n = 56) than the COMET group (60.7%, n = 25) and the difference was statistically significant (p = 0.01). In the COMET group, there was no statistically significant improvement in the visual acuity (VA) while in the ACLET group there was statistically significant improvement in the final VA. Elevated intraocular pressure (IOP) developed in 9 eyes (22.0%) in the COMET group and in 18 eyes (26.1%) in the ACLET group; infection developed in 4 eyes (9.8%) in the COMET group and in 10 eyes (14.5%) in the ACLET group; and perforation or melting happened in 4 eyes (9.8%) in the COMET group and in 1 eye (1.4%) in the ACLET group. Postoperative immunosuppression complications were noted in 9 eyes (13.0%) in the ACLET group. No graft rejection was observed in either group. Conclusion Both ACLET and COMET are effective therapeutic procedures for managing advanced and bilateral cases of LSCD. Although COMET has lower graft survival rate than ACLET, it does not mandate systemic immunosuppression therapy to protect against potential graft rejection.https://doi.org/10.1007/s40123-024-01083-xAllogeneic cultured limbal epithelial transplantationCultivated oral mucosal epithelial transplantationLimbal stem cell deficiencyPersistent epithelial defect |
| spellingShingle | Mohamed Elalfy Kareem Elsawah Sundas Maqsood Nigel Jordan Mansour Hassan Ahmed Zaki Zisis Gatzioufas Samer Hamada Damian Lake Allogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative Study Ophthalmology and Therapy Allogeneic cultured limbal epithelial transplantation Cultivated oral mucosal epithelial transplantation Limbal stem cell deficiency Persistent epithelial defect |
| title | Allogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative Study |
| title_full | Allogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative Study |
| title_fullStr | Allogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative Study |
| title_full_unstemmed | Allogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative Study |
| title_short | Allogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative Study |
| title_sort | allogenic cultured limbal epithelial transplantation and cultivated oral mucosal epithelial transplantation in limbal stem cells deficiency a comparative study |
| topic | Allogeneic cultured limbal epithelial transplantation Cultivated oral mucosal epithelial transplantation Limbal stem cell deficiency Persistent epithelial defect |
| url | https://doi.org/10.1007/s40123-024-01083-x |
| work_keys_str_mv | AT mohamedelalfy allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy AT kareemelsawah allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy AT sundasmaqsood allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy AT nigeljordan allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy AT mansourhassan allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy AT ahmedzaki allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy AT zisisgatzioufas allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy AT samerhamada allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy AT damianlake allogenicculturedlimbalepithelialtransplantationandcultivatedoralmucosalepithelialtransplantationinlimbalstemcellsdeficiencyacomparativestudy |