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Stem cell use in eye surgery

Sarah F Ahmed, Mason Schmutz, Sameh Mosaed
PURPOSE: Tube exposure remains one of the most common complications after glaucoma drainage device (GDD) implantation, despite various types of patch grafts available today. We present a 4 patient case series following the effectivity of the keratolimbal allograft (KLAL) as a patch graft for cases of tube exposure. Given its inherent population of stem cells, our hypothesis was that this highly replicative, biological tissue would provide an adequate means of glaucoma tube coverage. The subset of patients chosen for the KLAL patch graft all had a history of abnormally scarred conjunctiva or thin sclera...
July 20, 2017: Journal of Glaucoma
A O Minas Coroneo
Defending vision, our highest bandwidth sense, challenges human ingenuity. Replacing or repairing highly specialized but scarce tissue within constraints of transparency, tissue shape and alignment, tissue borders and pressure maintenance, presents special challenges. Many, mostly destructive surgical procedures, were developed prior to an understanding of underlying pathophysiology. For a number of conditions, both reconstructive and destructive procedures co-exist yet there are few guidelines as to the better approach...
July 17, 2017: Clinical & Experimental Ophthalmology
Gerd Geerling, Konrad Hille
In severe ocular surface disease with limbal stem cell deficiency associated with severe dry eye, penetrating keratoplasty is likely to fail. In these cases, and provided the posterior segment is normal, keratoprosthesis surgery (KPro) can achieve visual rehabilitation. In KPros with an autologous biological haptic, a bone-tooth-complex (osteo-odonto-keratoprothesis, OOKPro) or a piece of tibial cortex (tibia-keratoprosthesis, TKPro) is used to carry a PMMA cylinder. This construct can successfully be implanted even in severely dry eyes and in those with autoimmune disease, in which other KPro designs frequently fail...
June 2017: Klinische Monatsblätter Für Augenheilkunde
A Bryja, M Dyszkiewicz-Konwińska, J Budna, W Kranc, A Chachuła, S Borys, S Ciesiółka, J Sokalski, M Prylinski, D Bukowska, P Antosik, M Bruska, M Nowicki, M Zabel, B Kempisty
In recent years, there has been a growing interest in epithelial cell tissue culture, particularly oral mucosa and its application utilizing in vitro cell culture in medicine. This involves tests using animal models to better understand oral mucosa function, and the differences in its construction in various animal models. The use of buccal pouch mucosal cell culture provides insight into the processes of trans mucosal transport and regeneration of the oral epithelium. The processes associated with epithelium regeneration is the base for stem cell research and/or oral cancer investigation...
January 2017: Journal of Biological Regulators and Homeostatic Agents
Thiago Cabral, James E DiCarlo, Sally Justus, Jesse D Sengillo, Yu Xu, Stephen H Tsang
PURPOSE OF REVIEW: The present review seeks to summarize and discuss the application of clustered regularly interspaced short palindromic repeats (CRISPR)-associated systems (Cas) for genome editing, also called genome surgery, in the field of ophthalmology. RECENT FINDINGS: Precision medicine is an emerging approach for disease treatment and prevention that takes into account the variability of an individual's genetic sequence. Various groups have used CRISPR-Cas genome editing to make significant progress in mammalian preclinical models of eye disease, the basic science of eye development in zebrafish, the in vivo modification of ocular tissue, and the correction of stem cells with therapeutic applications...
May 2017: Current Opinion in Ophthalmology
Shilpa Das, Anand S Pasari, Virender S Sangwan
A 22-year-old male patient presented in 1988 with active vernal keratoconjunctivitis. He was treated with topical mast cell stabilisers and corticosteroids. Chronic inflammation despite topical treatment necessitated oral immunosuppressants. Active disease came under control with this; however, the patient gradually developed limbal stem cell deficiency. He underwent bilateral pannus resection with amniotic membrane transplantation that resulted in improved ocular surface. In 2007, patient was found to have significant bilateral posterior subcapsular cataracts and underwent bilateral cataract surgery with intraocular lens implantation with good visual outcome...
November 23, 2016: BMJ Case Reports
Özge Yanık, Kaan Gündüz, Kıvılcım Yavuz, Nurdan Taçyıldız, Emel Ünal
Retinoblastoma (RB) is the most common childhood malignant intraocular tumor. Although enucleation and external beam radiotherapy have been historically used, today the most commonly used eye-sparing approach is chemotherapy. Chemotherapy can be used in both intraocular and extraocular RB cases. Chemotherapeutic agents may be applied in different ways, including systemic, subconjunctival, intra-arterial and intravitreal routes. The main purposes of application of systemic therapy are to reduce the tumor size for local treatment (chemoreduction), or to reduce the risk of metastasis after enucleation surgery (adjuvant therapy)...
December 2015: Turkish Journal of Ophthalmology
Sudesh Kumar Arya, Anubha Bhatti, Amit Raj, Ravi Kant Bamotra
The epithelial cells of cornea constantly undergo renewal and regeneration and the stem cells responsible for renewal resides within basal epithelium at the limbus in palisades of Vogt. Simple limbal epithelial transplantation (SLET) is a simplified technique for limbal stem cell deficiency and it combines the benefits of both conjunctival limbal autografting and cultivated limbal epithelial transplantation by being single-stage and utilizing minimal donor tissue. We will be discussing two cases of ocular surface disorder which were managed successfully by new technique simple limbal epithelial transplantation...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Michael J Koss, Paulo Falabella, Francisco R Stefanini, Marcel Pfister, Biju B Thomas, Amir H Kashani, Rodrigo Brant, Danhong Zhu, Dennis O Clegg, David R Hinton, Mark S Humayun
PURPOSE: A subretinal implant termed CPCB-RPE1 is currently being developed to surgically replace dystrophic RPE in patients with dry age-related macular degeneration (AMD) and severe vision loss. CPCB-RPE1 is composed of a terminally differentiated, polarized human embryonic stem cell-derived RPE (hESC-RPE) monolayer pre-grown on a biocompatible, mesh-supported submicron parylene C membrane. The objective of the present delivery study was to assess the feasibility and 1-month safety of CPCB-RPE1 implantation in Yucatán minipigs, whose eyes are similar to human eyes in size and gross retinal anatomy...
August 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Biju B Thomas, Danhong Zhu, Li Zhang, Padmaja B Thomas, Yuntao Hu, Hossein Nazari, Francisco Stefanini, Paulo Falabella, Dennis O Clegg, David R Hinton, Mark S Humayun
PURPOSE: To determine the safety, survival, and functionality of human embryonic stem cell-derived RPE (hESC-RPE) cells seeded on a polymeric substrate (rCPCB-RPE1 implant) and implanted into the subretinal (SR) space of Royal College of Surgeons (RCS) rats. METHODS: Monolayers of hESC-RPE cells cultured on parylene membrane were transplanted into the SR space of 4-week-old RCS rats. Group 1 (n = 46) received vitronectin-coated parylene membrane without cells (rMSPM+VN), group 2 (n = 59) received rCPCB-RPE1 implants, and group 3 (n = 13) served as the control group...
May 1, 2016: Investigative Ophthalmology & Visual Science
Ana Gabriela Queiroz, Martina Maria Oiticica Barbosa, Myrna Serapião Santos, Telma Pereira Barreiro, José Álvaro Pereira Gomes
This study aimed to evaluate the effectiveness of the novel simple limbal epithelial transplantation (SLET) technique, which reduces the risk of iatrogenic limbal stem cell deficiency in the donor eye. Four patients with total unilateral limbal stem cell deficiency received a limbal graft, measuring 4 mm × 2 mm, from the contralateral healthy eye in a single surgical procedure. The graft was divided into 10-20 pieces and distributed on the corneal surface. At 6-month follow-up, a completely avascular corneal epithelial surface was obtained in two patients, and there was improvement in visual acuity in one patient...
April 2016: Arquivos Brasileiros de Oftalmologia
Michael G Daniel, Albert Y Wu
PURPOSE OF REVIEW: The review examines the utility of stem cell biology in ophthalmology and oculoplastic surgery. RECENT FINDINGS: The applicability of stem cell biology varies across a range of different subfields within ophthalmology and oculoplastic surgery. Resident stem cells have been identified in the lacrimal gland, corneal limbus, orbital fat, and muscles of the eye, and can potentially be applied for in-vitro cell and organ cultures with the intent of disease modeling and transplants...
September 2016: Current Opinion in Ophthalmology
Masayo Takahashi
Progress in basic research, starting with the work on neural stem cells in the middle 1990's to embryonic stem (ES) cells and induced pluripotent stem (iPS) cells at present, will lead the cell therapy (regenerative medicine) of various organs, including the central nervous system to a big medical field in the future. The author's group transplanted iPS cell-derived retinal pigment epithelial (RPE) cell sheets to the eye of a patient with exudative age-related macular degeneration (AMD) in 2014 as a clinical research...
March 2016: Nippon Ganka Gakkai Zasshi
Rodrigo A Brant Fernandes, Michael Janusz Koss, Paulo Falabella, Francisco Rosa Stefanini, Mauricio Maia, Bruno Diniz, Ramiro Ribeiro, Yuntao Hu, David Hinton, Dennis O Clegg, Gerald Chader, Mark S Humayun
BACKGROUND AND OBJECTIVE: To develop a safe and efficient surgical procedure for subretinal implantation into porcine eyes of a human embryonic stem cell-derived retinal pigmented epithelium (hESC-RPE) monolayer seeded onto a Parylene-C scaffold. This implant is referred to as CPCB-RPE1. MATERIALS AND METHODS: Ultrathin Parylene-C scaffolds were seeded with hESC-RPE and surgically implanted into the subretinal space of Yucatan mini pigs (n = 8). The surgery consisted of pars plana vitrectomy, induction of a limited retinal detachment, and peripheral retinotomy for insertion of the monolayer using a novel tissue injector, followed by silicone oil tamponade injection, laser photocoagulation around the retinotomy site, and inferior iridectomy...
April 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
Gábor Tóth, Franziska Bucher, Sebastian Siebelmann, Björn Bachmann, Manuel Hermann, Nóra Szentmáry, Zoltán Zsolt Nagy, Claus Cursiefen
PURPOSE: To present a new treatment modality for recurrent corneal melting in a patient with a Boston type I keratoprosthesis (B-KPro) including in situ corneal cross-linking (CXL) and lamellar keratoplasty (LKP) as combined treatment. METHODS: Case report. RESULTS: Our report concerns a 27-year-old man whose case history involved a severe chemical burn of his left eye. After failed penetrating keratoplasty and limbal stem cell transplantation, the patient underwent B-KPro implantation...
June 2016: Cornea
Ladan Espandar, Jessica F Steele, Kira L Lathrop
PURPOSE: To describe the use of volumetric optical coherence tomography (OCT) imaging to assist evaluation of a patient referred for autologous limbal stem-cell transplant. METHODS: This is a case report of a 50-year-old patient presenting with unilateral limbal stem-cell deficiency who was referred for autologous limbal stem-cell transplant. The presence of Salzmann nodules in the donor eye raised questions about the efficacy of transplantation, prompting examination of both eyes using volumetric OCT imaging to determine whether there were palisades of Vogt (POV) present...
January 16, 2016: Eye & Contact Lens
Saeed Heidari Keshel, Maryam Rostampour, Golbahar Khosropour, Atefehsadat Bandbon B, Alireza Baradaran-Rafii, Esmaeil Biazar
Injectable hydrogel is one of the great interests for tissue engineering and cell encapsulation. In the study, the thermosensitive chitosan/gelatin/β-glycerol phosphate (C/G/GP) disodium salt hydrogels were designed and investigated by different analyses. The eye fat-derived stem cells were used to evaluate the biocompatibility of hydrogels based on their phenotypic profile, viability, proliferation, and attachment ability. The results show that the sol/gel transition temperature of the C/G/GP hydrogel was in the range of 31...
2016: Journal of Biomaterials Science. Polymer Edition
Byeong Soo Kang, Mee Kum Kim, Won Ryang Wee, Joo Youn Oh
PURPOSE: To investigate the incidence, clinical and microbiological characteristics, risk factors, and therapeutic outcome of infectious keratitis in patients with limbal stem cell deficiency (LSCD) related to Stevens-Johnson syndrome (SJS) and corneal chemical burn. METHODS: Medical records of 90 eyes of 59 patients who were diagnosed with LSCD resulting from SJS (52 eyes of 29 patients) or corneal chemical burn (38 eyes of 30 patients) were reviewed. RESULTS: Infectious keratitis developed in 35% of LSCD patients with SJS (18 eyes, 14 patients) and in 18% of those with chemical burn (7 eyes, 7 patients)...
January 2016: Cornea
Carl Shen, Clara C Chan, Edward J Holland
PURPOSE: To describe the outcomes of limbal stem cell transplantation in eyes with limbal stem cell deficiency related to soft contact lens wear. DESIGN: Retrospective interventional case series. METHODS: Institutional database search at the Cincinnati Eye Institute revealed 9 patients (14 eyes) who underwent limbal stem cell transplantation with systemic immunosuppression for soft contact lens wear-related limbal stem cell deficiency. Outcome measures included patient demographics, symptoms, best-corrected visual acuity, ocular surface stability, adverse events, and additional surgeries required...
December 2015: American Journal of Ophthalmology
Kateryna Raykova, Melina V Jones, Hwa Huang, Paul F Hoffman, Michael Levy
The rat optic nerve is a useful model for stem cell regeneration research. Direct injection into the rat optic nerve allows delivery into the central nervous system in a minimally-invasive surgery without bone removal. This technique describes an approach to visualization and direct injection of the optic nerve following minor fascial dissection from the orbital ridge, using a conjunctival traction suture to gently pull the eye down and out. Representative examples of an injected optic nerve show successful injection of dyed beads...
May 19, 2015: Journal of Visualized Experiments: JoVE
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