Long-term Outcome of Limbal Epithelial Cells Cultivated in Vivo on Amniotic Membrane Transplantation

PURPOSE: To investigate the characteristics and the results of long-term follow-up of limbal epithelial cells cultivated in vivo on amniotic membranes (LIVAM) in corneal limbal deficiency. METHODS: Twenty-two eyes of twenty-two patients diagnosed with corneal limbal deficiency underwent transplantation of in vivo cultivated corneal limbal epithelial cells on the amniotic membrane. Biopsy and immunohistochemical staining (AE5, MUC5AC) of the amniotic membrane cultivated for one week were performed to verify that the cultivated epithelial cells on the amniotic membrane were corneal epithelial cells. Impression cytology was performed to evaluate the characteristics of the transplanted corneal limbal epithelial cells at postoperative 1 week, 3 months, 6 months, and 1 year. RESULTS: Successful epithelial growth was observed on the amniotic membrane at one week. The epithelial cells were confirmed to be corneal epithelial cells by immunohistochemical staining. Transplanted in vivo cultivated corneal epithelial cells were confirmed to have corneal specificity by impression cytology and immunohistochemical staining at postoperative 1 week, 3 months, 6 months, and 1 year. CONCLUSIONS: In vivo cultured corneal epithelial cells showed morphological and immunohistochemical findings similar to those of normal corneal epithelial cells. Transplanted in vivo cultivated corneal epithelial cells were maintained and showed the characteristics of corneal epithelial cells. Transplantation of in vivo cultivated corneal limbal epithelial cells can be performed to reconstruct the corneal limbus in treating corneal limbal deficiency.

The Comparison of The Matrix Perimetry and Humphrey Standard Perimetry in Various Patients Group

PURPOSE: To study the correlation between the Humphrey standard automated perimetry (SAP) and the Humphrey Matrix Frequency Doubling Technology (FDT) perimetry and diagnostic usefulness of the Humphrey Matrix FDT perimetry. METHODS: This study included 170 eyes of 170 patients. The 170 eyes were classified into 50 normal eyes, 20 ocular hypertensive eyes, 50 glaucoma-suspect eyes and 50 glaucomatous eyes. All subjects were examined with the Humphrey Matrix perimetry and the Humphrey standard automated perimetry. We studied the correlations between mean deviation (MD) and pattern standard deviation(PSD) of the Humphrey SAP and those of the Humphrey Matrix perimetry, respectively, in each of the classified group. RESULTS: Overall, MD and PSD of the Humphrey SAP were significantly correlated with MD and PSD of the Humphrey Matrix perimetry, respectively. However, MD and PSD of the Humphrey Matrix perimetry were not showed a significant correlation in normal subjects (P>0.05). CONCLUSIONS: In this study, there were significant correlations between the MD and PSD of the SAP and those of the Humphrey Matrix perimetry in glaucoma, glaucoma-suspect and ocular hypertension. These finding suggests the Humphrey Matrix perimetry has performance characteristics similar to SAP and diagnostic value.

Effect of Corticosteroids in the Treatment of Orbital Cellulitis with Subperiosteal Abscess

PURPOSE: To investigate the effect of corticosteroids in the treatment of orbital cellulites with subperiosteal abscess. METHODS: The medical records of 4 patients treated for orbital cellulitis with subperiosteal orbital abscess were reviewed. The class and dose of corticosteroids, surgical drainage, treatment course and clinical outcomes were reviewed. RESULTS: All patients received corticosteroids showed satisfactory results during 4.5 months of average follow up. Only one patient have been decreased visual acuity. Complications were minimal including mild hypokalemia, increased hepatic enzyme including aspartate aminotransferase and alanine aminotransferase. CONCLUSIONS: The use of corticosteroids may be beneficial in the treatment of orbital cellulitis with subperiosteal abscess.

Ocular Surface Squamous Neoplasia

PURPOSE: To assess the characteristics and treatments of ocular surface squamous neoplasms (OSSN). METHODS: We analyzed four representative cases of squamous neoplasms present on the ocular surface and discussed a new paradigm for the diagnosis and management of such lesions. CONCLUSIONS: Conjunctival and corneal tumors differentiated to squamous cells are rare. OSSN has various clinical appearances, and because OSSN itself is either malignant or has potential to become malignancy, precise discrimination and adequate treatment methods are necessary. We hope that the results from this study provide a basic source of information for diagnosing and treating OSSN.

The Characteristics of Limbal Epithelial Cells Auto-Cultivated In Vivo on Amniotic Membrane in Rabbits

PURPOSE: To investigate the characteristics of the limbal epithelial cells auto-cultivated in vivo on amniotic membrane (LIVAMs) designed for the treatment of limbal stem cell deficiency. METHODS: We removed the epithelium of AM with a No.15 blade after it was blotted with 20% ethanol and made a 360 degrees stromal flap along the epithelial defect. We then mounted over-sized AM (1 mm larger in diameter than the defect) over the defect with the border of AM inserted under the flap, and performed interrupted suture with 10-0 nylon. A therapeutic contact lens was fitted over the AM and a temporary tarsorrhaphy was performed. To examine whether the limbal epithelial cells grew well onto AM, we observed the cornea after fluorescein dye staining using a slit lamp. To explore the characteristics of LIVAMs, we performed hematoxylin-eosin (H&E) staining, immunochemical staining with AK-2, AE-5, AM-3 monoclonal antibodies, and transmission electron microscopy. RESULTS: Three of four rabbits had successful epithelial growth on the amniotic membrane. The epithelial growth on the amniotic membrane was stained using immunohistochemical staining (AK-2, AE-5). Electron microscopy showed a structure similar to that of a normal corneal epithelium. CONCLUSIONS: The technique of auto-cultivation of limbal epithelial cells in vivo on amniotic membrane can be an efficient and convenient method and preserves the characteristics of limbal epithelial cells for the treatment of limbal stem cell deficiency.