Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-0841 Japan.
Br J Ophthalmol. 2011 Jul;95(7):942-6. doi: 10.1136/bjo.2010.188714. Epub 2010 Nov 19.
To investigate the long-term outcome of autologous cultivated oral mucosal epithelial transplantation (COMET) for the treatment of the scar phase of severe ocular surface disorders. Participants This study involved 19 eyes of 17 patients who received autologous COMET for total limbal stem-cell deficiency.
Autologous cultivated oral mucosal epithelial sheets were created using amniotic membrane as a substrate. Clinical efficacy was evaluated by best-corrected visual acuity and visual acuity at the postoperative 36th month. The clinical results (clinical conjunctivalisation, corneal opacification, corneal neovascularisation and symblepharon formation) were evaluated and graded on a scale from 0 to 3 according to their severity. Clinical safety was evaluated by the presence of persistent epithelial defects, ocular hypertension and infections.
Autologous cultivated oral mucosal epithelial sheets were successfully generated for all 17 patients. All patients were followed up for more than 36 months; the mean follow-up period was 55 months and the longest follow-up period was 90 months. During the long-term follow-up period, postoperative conjunctivalisation and symblepharon were significantly inhibited. All eyes manifested various degrees of postoperative corneal neovascularisation, but it gradually abated and its activity was stable at 6 months after surgery. Best-corrected visual acuity was improved in 18 eyes (95%) during the follow-up periods, and visual acuity at the postoperative 36th month was improved in 10 eyes (53%).
These long-term clinical results strongly support the conclusion that tissue-engineered cultivated oral mucosal epithelial sheets are useful in reconstructing the ocular surface of the scar phase of severe ocular surface disorders.
研究自体培养口腔黏膜上皮移植（COMET）治疗严重眼表疾病瘢痕期的长期疗效。
本研究共纳入 17 例 19 眼接受自体 COMET 治疗的完全性角膜缘干细胞缺乏患者。
采用羊膜作为基底膜培养自体口腔黏膜上皮细胞。通过最佳矫正视力和术后 36 个月的视力评估临床疗效。根据严重程度，临床结果（临床结膜化、角膜混浊、角膜新生血管和睑球粘连形成）在 0 至 3 分的范围内进行评估和分级。通过持续性上皮缺损、眼压升高和感染评估临床安全性。
所有 17 例患者均成功生成自体培养口腔黏膜上皮细胞。所有患者均随访超过 36 个月，平均随访时间为 55 个月，最长随访时间为 90 个月。在长期随访期间，术后结膜化和睑球粘连得到明显抑制。所有眼均表现出不同程度的术后角膜新生血管，但术后 6 个月逐渐减轻，其活动度稳定。在随访期间，18 只眼（95%）的最佳矫正视力得到改善，10 只眼（53%）的术后 36 个月视力得到改善。
这些长期的临床结果有力地支持了组织工程化培养口腔黏膜上皮细胞在重建严重眼表疾病瘢痕期眼表方面的有效性。
