Goto Hiroki, Ono Takashi, Taketani Yukako, Kimakura Mikiko, Toyono Tetsuya, Miyai Takashi, Aihara Makoto
Ophthalmology, University of Tokyo Hospital, Tokyo, JPN.
Ophthalmology, University of Tokyo, Tokyo, JPN.
Cureus. 2025 Mar 28;17(3):e81341. doi: 10.7759/cureus.81341. eCollection 2025 Mar.
This study aimed to examine the changes in intraocular pressure (IOP) after commercially available cultivated oral mucosal epithelial cell transplantation (COMET) in Japanese patients with limbal stem cell deficiency (LSCD).
This retrospective observational study included consecutive patients who underwent commercially available COMET (Ocural®, Japan Tissue Engineering Co., Ltd. (J-TEC), Tokyo, Japan, and Nidek Co., Ltd., Gamagori, Japan) for LSCD at the University of Tokyo Hospital from January to December 2023. Their medical charts were reviewed for background information, IOP measurements, medication use, and surgery for IOP elevation before and one day, one week, one month, three months, and six months after COMET and the final follow-up point.
Nine eyes from nine patients (mean age: 59.7±12.4 years) were included in the study. The primary diseases associated with LSCD were chemical burns (three eyes), Stevens-Johnson syndrome (two eyes), congenital aniridia (two eyes), and others (two eyes). IOP was significantly elevated from 9.7±4.1 mmHg before surgery to 23.0±12.3 mmHg one day after surgery (p=0.008) and to 20.2±7.0 mmHg one week after surgery (p=0.006). IOP was uncontrollable with eye drops in one eye (11.1%) two weeks after surgery, necessitating three sessions of micropulse transscleral cyclophotocoagulation. The mean number of antiglaucoma medications used did not change significantly during the observation period.
Commercially available COMET induces IOP elevation during the early postoperative period. Most cases of IOP elevation can be controlled with adequate management, but some instances of uncontrolled IOP necessitate careful consideration.
本研究旨在探讨在日本患有角膜缘干细胞缺乏症（LSCD）的患者中，使用市售培养口腔黏膜上皮细胞移植（COMET）后眼压（IOP）的变化。
这项回顾性观察研究纳入了2023年1月至12月在东京大学医院因LSCD接受市售COMET（Ocural®，日本组织工程有限公司（J-TEC），东京，日本，以及尼德克有限公司，蒲郡，日本）治疗的连续患者。回顾他们的病历，以获取COMET术前及术后1天、1周、1个月、3个月、6个月以及最后随访点的背景信息、IOP测量值、药物使用情况以及因IOP升高而进行的手术情况。
本研究纳入了9例患者的9只眼（平均年龄：59.7±12.4岁）。与LSCD相关的主要疾病为化学烧伤（3只眼）、史蒂文斯-约翰逊综合征（2只眼）、先天性无虹膜（2只眼）以及其他（2只眼）。IOP在术前为9.7±4.1 mmHg，术后1天显著升高至23.0±12.3 mmHg（p = 0.008），术后1周升高至20.2±7.0 mmHg（p = 0.006）。术后2周，1只眼（11.1%）的IOP无法通过眼药水控制，需要进行3次微脉冲经巩膜睫状体光凝术。在观察期内，抗青光眼药物的平均使用数量没有显著变化。
市售COMET在术后早期会导致IOP升高。大多数IOP升高的病例通过适当管理可以得到控制，但有些IOP无法控制的情况需要仔细考虑。
