Buccal mucosa provides cells for reconstructing corneal epithelium

PARIS — Autologous transplantation of an epithelial sheet created from buccal mucosa stem cells is proving to be an effective means of treating patients with bilateral corneal stem cell deficiency, according to a study carried out in Lyon, France.

The cells are removed with a small biopsy and cultured on a thermosensitive substrate polymer, which allows removal of the newly formed epithelial sheet without enzymatic procedures, maintaining an intact basal membrane. A ring-shaped portion of this sheet is then positioned on the eye and protected with a therapeutic contact lens.

Fourteen patients with corneal decompensation, mostly due to thermal eye burn, Stevens-Johnson syndrome or bilateral pemphigoid, were treated.

"Results were encouraging. Corneal ulcers disappeared, neovascularization was reduced, and functional symptoms, like pain, photophobia and dry eye, improved significantly. Visual acuity improved only in eight patients who presented less dense stromal opacities," Carole Burillon, MD, said.

One failure was reported in one patient with Lyell syndrome who presented with severe inflammation with corneal perforation.