Iris pigment epithelium transplantation — experimental and clinical results
It has been hypothesized that transplantation of iris pigment epithelial (IPE) cells to the subretinal space may be useful in the treatment of exudative age-related macular degeneration following surgical removal of the neovascular complex. In practice, the success of IPE transplantation depends on (a) the transplantation of a sufficient number of IPE cells, (b) the ability of the transplanted IPE cells to form a monolayer that will cover the exposed photoreceptor outer segments, and (c) the acquisition of RPE cell characteristics and functions by the transplanted IPE cells.
We have transplanted autologous IPE cells as a single cell suspension to the subretinal space in 20 patients; during the three years of follow-up the cells survived and did not adversely affect photoreceptors function. Stabilization of visual acuity was achieved in the majority of patients after IPE transplantation, and by fluorescein angiography none of the twenty patients showed any sign of recurrent vascular disease. The transplanted cells appeared to have remained at the site of transplantation, however it was not possible to ascertain whether they had spread and formed a monolayer. Since the formation of a monolayer of cells is critical to the successful visual outcome of IPE transplantation, we have begun a series of experiments to optimize the culture of IPE and RPE cells and explore the feasibility of transplanting preformed monolayers of autologous IPE cells cultured on biodegradable substrates.
KeywordsRetinal Pigment Epithelial Retinal Pigment Epithelial Cell Early Treatment Diabetic Retinopathy Study Subretinal Space Choroidal Neovascular Membrane
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