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KMID : 0191120080230030502
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Journal of Korean Medical Science
2008 Volume.23 No. 3 p.502 ~ p.508
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The Effect of In Vivo Grown Corneal Epithelium Transplantation on Persistent Epithelial Defects with Limbal Stem Cell Deficiency
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Kim Jee-Tae
Kim Jae-Chan
Chun Yeoun-Sook
Song Geo-Young
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Abstract
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We report our experience with corneal epithelium, grown in vivo, transplantation in
three patients with persistent epithelial defect (PED). The three patients had ocular
surface disease unresponsive to standard treatments and were therefore chosen
for transplantation. They underwent transplantation of epithelial sheets, grown in
vivo, to the most affected eye. In vivo cultivation was carried out in the cornea of a
living related donor. After epithelialization was completed, the epithelium grown on
an amniotic membrane was harvested gently; it was then transplanted into the
patient’s eye after debridement of fibrovascular tissue. The cultivated epithelium
was completely epithelialized by 2 weeks; it was well-differentiated with well-formed
hemidesmosome. On immunohistochemical staining, p63, connexin 43, and Integrin
β4 were expressed in the cells on the epithelial sheet. The PED was covered
completely and maintained for 4 weeks in all cases. However, corneal erosion
recurred after 5 weeks in two cases. This novel technique demonstrates the corneal
epithelial cells can be expanded in vivo successfully on denuded amniotic membrane
of a healthy cornea and harvested safely. A corneal epithelial sheet, grown in
vivo, can be transplanted to treat eye with a severe ocular surface disease, such
as total limbal deficiency.
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KEYWORD
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Amnion, Epithelium, Corneal, Limbus Corneae, Tissue Expansion
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