Transplantation of human limbal epithelium cultivated on amniotic membrane for the treatment of severe ocular surface disorders

Ophthalmology. 2002 Jul;109(7):1285-90. doi: 10.1016/s0161-6420(02)01089-8.


Purpose: To study the short-term clinical results of transplanting of cultivated corneal/limbal epithelial cells on human amniotic membrane (AM) for limbal deficiency.

Design: Noncomparative, retrospective interventional case series.

Participants: Thirteen eyes of 13 patients with severe limbal deficiency (Stevens-Johnson syndrome in eight eyes, ocular cicatricial pemphigoid in three eyes, and chemical burns in two eyes) were treated at the department of Ophthalmology, Tokyo Dental College, Japan.

Intervention: Cultivated allo-limbal epithelium was transplanted onto the ocular surface of patients with severe limbal deficiency.

Main outcome measures: Ocular surface reconstruction with corneal epithelialization, changes in visual acuity, and postoperative complications were studied. Histologic examinations were also performed on cultivated epithelium.

Results: Cultivated corneal epithelium on AM formed two to three layers with the formation of basement membrane-like structures. After the surgery, the epithelium regenerated and covered the ocular surface in eight eyes (61.5%). However, three of the eight eyes developed partial conjunctival invasion, and two eyes later developed epithelial defects. At last examination, corneal epithelialization was achieved in six eyes (46.2%). Five eyes had conjunctivalization, one eye had dermal epithelialization, and one eye was not epithelialized. Complications were corneal perforation in four eyes and infectious keratitis in two eyes.

Conclusions: This study demonstrates that the success rate for transplanting cultivated allo-limbal epithelium on the AM is not different from the conventional limbal and AM transplantation for the treatment of severe limbal stem cell dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amnion
  • Cell Culture Techniques / methods
  • Cell Transplantation
  • Cells, Cultured
  • Corneal Diseases / surgery*
  • Epithelium, Corneal / cytology
  • Epithelium, Corneal / transplantation*
  • Female
  • Graft Survival
  • Humans
  • Limbus Corneae / cytology*
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retrospective Studies
  • Stem Cell Transplantation*
  • Stem Cells / cytology
  • Treatment Outcome
  • Visual Acuity