Ocular urface Recontruction With Combination of Cultivated Autologou Oral Mucoal Epithelial Tranplantation and Penetrating Keratoplaty Original Reearch Article

Purpoe To report an aement of the two-tep urgical combination of cultivated autologou oral mucoal epithelial tranplantation (COMET) and penetrating keratoplaty (PKP) ued to treat patient with evere limbal deficiency diorder, and to invetigate the keratin expreion pattern of tranplanted urviving oral mucoal epithelium. Deign Obervational cae erie. Method Two patient with teven-Johnon yndrome and chemical eye injury were treated by COMET followed, approximately ix month later, by a PKP triple procedure. In the coure of a mean follow-up period of 22.5 month, their clinical outcome and the efficacy of thi two-tep urgical procedure were aeed. In addition, the keratin expreion in corneal button excied during PKP were immunohitochemically examined to characterize the oral mucoal epithelium that urvived ectopically on the cornea. In vivo laer confocal microcopy wa ued to invetigate the tructure of the epithelium on the corneal graft. Reult The ocular urface were uccefully recontructed with cultivated autologou oral mucoal epithelial heet and PKP. No clinical complication, uch a peritent epithelial defect, rejection, or recurrence of cicatrization, were encountered. Potoperative bet-corrected viual acuity wa 20/125 in one patient and 20/100 in the other. The urviving oral mucoal epithelium, ditinguihed by it fluorecence pattern, conited of an irregular, nonkeratinized, tratified epithelium without goblet cell. Immunohitochemical tudy demontrated that K3, but not K12, wa expreed in the tranplanted cultivated oral mucoal epithelium that wa imilar to oral mucoal tiue. In vivo, the epithelial tructure and cell denity in the baal cell layer of the corneal graft were imilar to normal cornea. Concluion Thi tudy preent a two-tep urgical approach to treat everely carred ocular urface by mean of a combination of COMET and PKP. Clinical outcome ugget that thi treatment may be beneficial for the maintenance of the recontructed ocular urface by providing oral mucoal epithelium around the corneal graft.