Outcomes of Cultivated Oral Mucosal Epithelial Transplantation in Eyes With Chronic Stevens-Johnson Syndrome Sequelae

Venugopal, Renu; Nagpal, Ritu; Mohanty, Sujata; Sen, Seema; Kashyap, Seema; Agarwal, Tushar; Maharana, Prafulla K.; Vajpayee, Rasik B; Sharma, Namrata

doi:10.1016/j.ajo.2020.08.022

Cited by 16 publications

(12 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fornix reconstruction and symblepharon release using an amniotic membrane (AM), MMG or with COMET (cultivated oral mucosal epithelial transplantation) help address unstable tear film, exposure keratopathy and improved fitting of PROSE lenses in eyes with shortened fornices (9, 10, 29, 30) (Figures 3a,b). Outcomes of COMET in eyes with SJS/TEN have been described from two centers in India with both showing improved outcomes and restoration of the anatomy of the ocular surface (31,32). Successful resolution of recurrent cicatricial entropion due to SJS/TEN was shown by Singh et al with the use of labial mucosa for spacing the anterior lamella and reconstruction of the lid margin and posterior lamella with minimal recurrence rate at a follow-up period of 16 months (33).…”

Section: Fornix Reconstruction and Adnexal Proceduresmentioning

confidence: 99%

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

et al. 2021

View full text Add to dashboard Cite

Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular, with significant mortality rates. The chronic phase is characterized by multi-organ sequelae with increased rates of morbidity and reduced quality of life for patients who have survived the acute phase. Since the primary goal in the acute phase is saving the life of the patient, ocular involvement is often missed and a significant proportion of patients present to an ophthalmologist with the chronic ocular sequelae. In India, chronic ocular sequelae and low vision are observed in two-thirds of patients who present in the chronic phase of SJS/TEN. In the chronic phase of ocular involvement, there are definite windows of opportunity which if targeted with specific interventions such as scleral lenses and mucous membrane grafts can help reduce the incidence of corneal blindness and improve the quality of life for patients with SJS/TEN. Over the last decade, several studies from India have advanced the understanding of the natural course of ocular involvement in SJS/TEN and the outcomes of timely interventions in the chronic phase of the disease. We present an overview of the epidemiology of ocular complications of SJS/TEN in India, the specific challenges faced in the management of ocular complications in the acute stage and recent advances in management of the chronic ocular complications of the disease.

show abstract

Section: Fornix Reconstruction and Adnexal Proceduresmentioning

confidence: 99%

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

et al. 2021

View full text Add to dashboard Cite

show abstract

“… 21 , 23 Since the autologous tissue used in COMET is readily available, it is an excellent alternative to surgical methods involving cultivated limbal epithelial cells for the restoration of vision in patients with total LSCD. 22 However, the cost of the preparation of the cultivated cells used for COMET is high.…”

Section: Discussionmentioning

confidence: 99%

“… 21 Moreover, several other studies have reported performing COMET in SJS cases, yet the results have varied. 22 , 23 …”

Section: Introductionmentioning

confidence: 99%

Challenges in the management of bilateral eyelid closure in Stevens-Johnson Syndrome

Aziza

Harada

Ueta

et al. 2022

American Journal of Ophthalmology Case Reports

View full text Add to dashboard Cite

“…In a retrospective cohort study from 2002 to 2008, COMET had a success probability of 79.6% for overall fornix-reconstruction, of 100% for thermal/chemical injury and of 53.3% for ocular cicatricial pemphigoid, respectively, at five years postoperatively [ 281 ]. In a prospective interventional case series from 2013 to 2017, which included eyes that received COMET because of chronic Stevens-Johnson syndrome sequelae, 82.2% (37/45) of eyes had an improvement in visual acuity, 13.3% (6/45) presented with no change, whereas 4.4% (2/45) of eyes had worsening of visual acuity [ 282 ]. Cabral et al summarized 14 studies on COMET, which obtained tissue samples from the buccal mucosa and two studies that obtained tissue from the lip from 2004 to 2019 [ 283 ].…”

Section: Therapy Of Lscdmentioning

confidence: 99%

Corneal Epithelial Stem Cells–Physiology, Pathophysiology and Therapeutic Options

Ruan

Jiang

Musayeva

et al. 2021

Cells

View full text Add to dashboard Cite

In the human cornea, regeneration of the epithelium is regulated by the stem cell reservoir of the limbus, which is the marginal region of the cornea representing the anatomical and functional border between the corneal and conjunctival epithelium. In support of this concept, extensive limbal damage, e.g., by chemical or thermal injury, inflammation, or surgery, may induce limbal stem cell deficiency (LSCD) leading to vascularization and opacification of the cornea and eventually vision loss. These acquired forms of limbal stem cell deficiency may occur uni- or bilaterally, which is important for the choice of treatment. Moreover, a variety of inherited diseases, such as congenital aniridia or dyskeratosis congenita, are characterized by LSCD typically occurring bilaterally. Several techniques of autologous and allogenic stem cell transplantation have been established. The limbus can be restored by transplantation of whole limbal grafts, small limbal biopsies or by ex vivo-expanded limbal cells. In this review, the physiology of the corneal epithelium, the pathophysiology of LSCD, and the therapeutic options will be presented.

show abstract

Outcomes of Cultivated Oral Mucosal Epithelial Transplantation in Eyes With Chronic Stevens-Johnson Syndrome Sequelae

Cited by 16 publications

References 20 publications

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Challenges in the management of bilateral eyelid closure in Stevens-Johnson Syndrome

Corneal Epithelial Stem Cells–Physiology, Pathophysiology and Therapeutic Options

Contact Info

Product

Resources

About