The effect of Cultured Autologous Oral Mucosal Epithelial Cell Sheet (CAOMECS) on the ocular surface reconstruction

Abstract

IntroductionOral epithelial cells were recently shown to be able to differentiate into corneal epithelium and the efficacy of CAOMEC has been suggested by the presence of epithelium replacement. Therefore, the aim was to evaluate the treatment outcome in limbal stem cell deficiency (LSCD) by adding the CAOMEC to the regular amniotic membrane (AM) treatment.Material and methodsEyes with LSCD were randomized in two groups to undergo either CAOMECS combined with AM transplantation (A group) or AM transplantation alone (B group). Clinical outcome measures were corneal epithelium healing, best corrected visual acuity, symblepharon, corneal transparency, corneal neovascularization and ocular surface inflammation.ResultsThe normal corneal epithelialization rate in group A (73.33%) was higher than that in group B (35.48%), and the average healing time was shorter (3.45 ± 2.12 w vs.4.64 ± 1.63). The symblepharon in above two groups were improved in the first 3 m after surgery, however, after 6 m, part of the B group had recurrence. In improving corneal transparency, group A has obvious advantages. Corneal neovascularization (CNV) was improved to some extent in the first 3 m after surgery, but group A (1.47 ± 0.64) was better than group B (1.94 ± 0.85) after 6 m. Both groups can improve the inflammatory state to some extent.ConclusionsThe transplantation of CAOMECS offers a viable and safe alternative in the reconstruction of a stable ocular surface. The effect is better than that of traditional AM transplantation, mainly in promoting corneal epithelialization, improving ocular surface structure, reducing fiber and vascular infiltration.