Autologous serum-derived epithelial cells may be effective transplant source

Corneal epithelial cells cultivated in autologous serum may be an effective transplant source for treating patients with severe ocular surface disease, a case series suggests.

Takahiro Nakamura, MD, PhD, and colleagues at Kyoto Prefectural University of Medicine, Japan, retrospectively reviewed the outcomes of corneal epithelial cell transplantation in nine eyes of nine patients with total limbal stem cell deficiencies. In all cases, the researchers used autologous serum to cultivate corneal epithelial cells on an amniotic membrane substrate. They then compared these autologous serum-derived "corneal epithelial equivalents" with cells derived from a medium supplemented with fetal bovine serum.

Surgeons completely removed the corneal pannus and conjunctiva up to 3 mm from the limbus in all cases before transplanting the cultivated cells. Seven eyes received allogeneic and two eyes received autologous cultivated equivalent cells, according to the study.

"The corneal epithelial sheets cultivated in [autologous serum]- and [fetal bovine serum]-supplemented media were morphologically similar, and demonstrated the normal expression of tissue-specific keratins and junctional specialization assembly proteins," the authors said.

Patients achieved complete corneal epithelialization within 2 to 5 days postop, and visual acuity in all eyes improved by at least two lines. In addition, the corneal surfaces of all eyes remained transparent, stable and without significant complications at a mean follow-up of 14.6 months, according to the study.

Autologous serum is important for developing autologous xenobiotic-free bioengineered ocular surface transplant sources, the authors said.

The study is published in the October issue of Ophthalmology.