Transplantation of the oral mucosa epithelial layer in the treatment of corneal defects with limbal stem cell deficiency

Abstract

BACKGROUND: Corneal epithelialization occurs due to proliferation and differentiation of limbal stem epithelial cells. Death of these cells or damage of its microenvironment leads to limbal stem cell deficiency. In bilateral total limbal damage (both eyes), autologues limbal stem cells transplantation becomes impossible. So, it is revalent to find new sources of autologous progenitor cells. One of such sources are buccal cells from cheek mucosa. AIM: To study the reparative effect of buccal cells in oral mucosa autologous epithelial layer in a mechanical limbal stem cell deficiency model. MATERIALS AND METHODS: The study was conducted on 7 Chinchilla rabbits (14 eyes). At the first stage, rabbits underwent bilateral total limbectomy and mechanical de-epithelialization of the cornea resulted in fibrovascular pannus development. Then, a full-layer flap of the cheek mucosa measuring 5 5 mm was taken, and epithelial layer was separated by 0.5% dispase solution. After superficial keratectomy to transparent layers, a layer of buccal epithelium was placed to the cornea and covered with a soft contact lens. In controls soft contact lens, was placed on the cornea. Temporary tarsorrhaphy was performed for 5 days. In the postoperative period, the area of the deepithelized surface, neovascularization and corneal transparency were evaluated. RESULTS: On the 7th30th day, a reduction of erosion was noted in experimental and control eyes, but the dynamics of recovery processes did not significantly differ. On day 60, the area of erosion in the experimental eyes was significantly less than in the control (p = 0.038). Recurrence of erosion was noted in 4 control and 3 experimental eyes. CONCLUSIONS: In our model of limbal stem cell deficiency, the use of a buccal epithelium layer did not reveal a pronounced reparative effect.