Advertisement

Cell Therapy Using Cultivated Oral Mucosal Epithelial Transplant (COMET)

  • Roberto Fernández Buenaga
  • Sajjad Ahmad
Chapter
Part of the Essentials in Ophthalmology book series (ESSENTIALS)

Abstract

A significant proportion of patients with limbal stem cell failure (LSCF) have bilateral disease. In these cases, there is most often no area of healthy limbus in either eye to use a source of donor limbal stem cells. Therefore, limbal allograft procedures (either allogeneic whole limbal tissue grafting, allo-CLET, or allo-SLET) become the only valid treatment options. However, these procedures are accompanied by the risk of rejection and the requirement of potent systemic immune suppression. The rationale of COMET is to overcome these drawbacks by means of using autologous mucosal epithelium of non-ocular surface origin.

Keywords

Limbal failure COMET Chemical burn Cicatrising conjunctivitis 

Notes

Compliance with Ethical Requirements

Sajjad Ahmad and Roberto Fernandez Buenaga declare that they have no conflict of interest. No human or animal studies were carried out by the authors for this chapter.

References

  1. 1.
    Ballen PH. Mucous membrane grafts in chemical (eye) burns. Am J Ophthalmol. 1963;55:302–12.CrossRefGoogle Scholar
  2. 2.
    Gipson IK, Geggel HS, Spurr-Michaud SJ. Transplant of oral mucosal epithelium to rabbit ocular surface wounds in vivo. Arch Ophthalmol. 1986;104:1529–33.CrossRefGoogle Scholar
  3. 3.
    Nakamura T, Endo K, Cooper L, et al. The successful culture and autologous transplantation of rabbit oral mucosal epithelial cells on amniotic membrane. Invest Ophthalmol Vis Sci. 2003;44:106–16.CrossRefGoogle Scholar
  4. 4.
    Nakamura T, Inatomi T, Cooper LJ, et al. Phenotypic investigation of human eyes with transplanted autologous cultivated oral mucosal epithelial sheets for severe ocular surface diseases. Ophthalmology. 2007;114(6):1080–8.CrossRefGoogle Scholar
  5. 5.
    Satake Y, Dogru M, Yamane GY, et al. Barrier function and cytologic features of the ocular surface epithelium after autologous cultivated oral mucosal epithelial transplantation. Arch Ophthalmol. 2008;126(1):23–8.CrossRefGoogle Scholar
  6. 6.
    Kolli S, Ahmad S, Mudhar HS, et al. Successful application of ex vivo expanded human autologous oral mucosal epithelium for the treatment of total bilateral limbal stem cell deficiency. Stem Cells. 2014;32(8):2135–46.CrossRefGoogle Scholar
  7. 7.
    Sotozono C, Inatomi T, Nakamura T, et al. Cultivated oral mucosal epithelial transplantation for persistent epithelial defect in severe ocular surface diseases with acute inflammatory activity. Acta Ophthalmol. 2014;92(6):e447–53.CrossRefGoogle Scholar
  8. 8.
    Satake Y, Higa K, Tsubota K, et al. Long-term outcome of cultivated oral mucosal epithelial sheet transplantation in treatment of total limbal stem cell deficiency. Ophthalmology. 2011;118:1524–30.CrossRefGoogle Scholar
  9. 9.
    Nakamura T, Takeda K, Inatomi T, et al. Long-term results of autologous cultivated oral mucosal epithelial transplantation in the scar phase of severe ocular surface disorders. Br J Ophthalmol. 2011;95(7):942–6.CrossRefGoogle Scholar
  10. 10.
    Prabhasawat P, Ekpo P, Uiprasertkul M, et al. Long-term result of autologous cultivated oral mucosal epithelial transplantation for severe ocular surface disease. Cell Tissue Bank. 2016;17(3):491–503.CrossRefGoogle Scholar
  11. 11.
    Inatomi T, Nakamura T, Kojyo M, et al. Ocular surface reconstruction with combination of cultivated autologous oral mucosal epithelial transplantation and penetrating keratoplasty. Am J Ophthalmol. 2006;142(5):757–64.CrossRefGoogle Scholar
  12. 12.
    Baradaran-Rafii A, Delfazayebaher S, Aghdami N, et al. Midterm outcomes of penetrating keratoplasty after cultivated oral mucosal epithelial transplantation in chemical burn. Ocul Surf. 2017;15(4):789–94.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Roberto Fernández Buenaga
    • 1
  • Sajjad Ahmad
    • 2
  1. 1.Cornea, Cataract and Refractive Surgery DepartmentVissum MadridMadridSpain
  2. 2.Cornea and External Diseases DepartmentMoorfields Eye HospitalLondonUK

Personalised recommendations