Allogenic Cultured Limbal Epithelial Transplantation and Cultivated Oral Mucosal Epithelial Transplantation in Limbal Stem Cells Deficiency: A Comparative Study.

Publisher: Springer Healthcare Country of Publication: England NLM ID: 101634502 Publication Model: Print-Electronic Cited Medium: Print ISSN: 2193-8245 (Print) NLM ISO Abbreviation: Ophthalmol Ther Subsets: PubMed not MEDLINE

Original Publication: [London] : Springer Healthcare

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.
Competing Interests: Declarations. Conflict of Interest: All named authors confirm that they have no conflict of interest to disclose. Zisis Gatzioufas is an Editorial Board member of Ophthalmology and Therapy. Zisis Gatzioufas was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decision. The authors have no propriety or commercial interest in any materials discussed in this article. Ethical Approval: This study was conducted in accordance with the principles outlined in the Helsinki Declaration of 1964 and its later amendments.
(© 2025. The Author(s).)

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Keywords: Allogeneic cultured limbal epithelial transplantation; Cultivated oral mucosal epithelial transplantation; Limbal stem cell deficiency; Persistent epithelial defect

Date Created: 20250104 Latest Revision: 20250129

20250129

PMC11754549

10.1007/s40123-024-01083-x

39755899