TY - JOUR TI - Long-term outcomes of cultivated cell sheet transplantation for treating total limbal stem cell deficiency AU - Shimazaki, Jun AU - Satake, Yoshiyuki AU - Higa, Kazunari AU - Yamaguchi, Takefumi AU - Noma, Hisashi AU - Tsubota, Kazuo T2 - The Ocular Surface AB - Purpose This study was conducted to determine the long-term outcomes of cultivated cell sheet transplantation (CCST), and to clarify risk factors that affected the outcomes. Methods We retrospectively analyzed the medical charts and photographs of 246 consecutive surgeries (162 eyes from 139 patients) that used CCST for treating total limbal stem cell deficiency. Deficiency types included Stevens–Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN; n = 80), ocular surface burns (Burn; n = 75), ocular cicatricial pemphigoid (OCP) or pseudo-OCP (n = 58), and others (n = 33). The methods of CCST included 103 cultivated limbal epithelial transplantations (28 autologous, 62 allogeneic, and 13 living and related relatives), and 143 cultivated oral mucosal epithelial transplantations. We analyzed the rate of successful ocular surface reconstruction, clear corneas, and best-corrected visual acuity equal to or better than 20/200. Results With a mean observation period of 357 weeks, successful ocular surface reconstruction and clear corneas at last visit were achieved in 65.1% of the patients. Corrected visual acuity equal to or better than 20/200 was achieved in 19.0% of the patients. Eyes with SJS/TEN exhibited worse outcomes compared with the Burn group. Postoperative complications included corneal ulcerations or perforations (18.3%), glaucoma (13.8%), and infections (8.5%). Multivariate analyses using the logistic mixed-effects model indicated that the presence of preoperative corneal epithelial defects was a significant risk factor for postoperative failure. Conclusions In this series, the success rate of CCST after a mean observation period of 357 weeks was 65.1%, and preoperative epithelial defect was the most relevant risk factor. DA - 2020/06/27/ PY - 2020 DO - 10.1016/j.jtos.2020.06.005 DP - ScienceDirect J2 - The Ocular Surface LA - en SN - 1542-0124 UR - http://www.sciencedirect.com/science/article/pii/S1542012420301026 Y2 - 2020/07/06/18:24:43 KW - Corneal epithelium KW - Limbal stem cell deficiency KW - Ocular surface KW - Regenerative medicine ER -