Corneal Stromal Regeneration Therapy for Advanced Keratoconus: Long-term Outcomes at 3 Years
Por:
El Zarif, M, Alio, J, del Barrio, J, Jawad, K, Palazon-Bru, A, Jawad, Z, De Miguel, M and Makdissy, N
Publicada:
1 jun 2021
Resumen:
Purpose: To report the 3-year clinical outcomes of corneal stromal cell therapy consisting of the intrastromal implantation with autologous adipose-derived adult stem cells (ADASCs), and decellularized or ADASC-recellularized human donor corneal laminas in advanced keratoconus.
Methods: Fourteen patients were enrolled in 3 experimental groups. Group 1 (G-1) patients underwent implantation of ADASCs alone (3 x 10(6) cells/1 mL) (n = 5). Group 2 (G-2) patients received a 120-mu m decellularized corneal stroma lamina (n = 5). Group 3 (G-3) patients received a 120-mm lamina recellularized with ADASCs (1 x 10(6) cells/1 mL) (n = 4). ADASCs were obtained by elective liposuction. Implantation was performed into a femtosecond pocket under topical anesthesia.
Results: At 3 years, a significant improvement of 1 to 2 logMAR lines in uncorrected distance visual acuity was observed in all groups. A statistically significant decrease in corrected distance visual acuity was obtained in G-2 and G-3 (P<0.001) when compared with that of G-1. Rigid contact lens distance visual acuity showed a statistically significant worsening in G-2 (P<0.001) compared with that of G-1. A statistically significant increase in central corneal thickness was observed in G-2 (P = 0.012) and G-3 (P<0.001); in the Scheimpflug corneal topography, the thinnest point was observed in G-2 (P = 0.007) and G-3 (P = 0.001) when compared with that of G-1.
Conclusions: Intrastromal implantation of ADASCs and decellularized or ADASC-recellularized human corneal stroma laminas did not have complications at 3 years. The technique showed a moderate improvement in (uncorrected distance visual acuity) and (corrected distance visual acuity) in advanced keratoconus.
Filiaciones:
El Zarif, M:
Lebaneese Univ Hadath EDST Biotechnol, Opt Gen, Saida, Lebanon
Univ Miguel Hernandez Univ, Div Ophthalmol, Alicante, Spain
Lebanese Univ, Lebaneese Univ Hadath EDST Biotechnol, Doctoral Sch Sci & Technol, Hadath, Lebanon
Lebanese Univ, Fac Sci, GSBT Genom Surveillance & Biotherapy Team, Hadath, Lebanon
Alio, J:
Univ Miguel Hernandez Univ, Div Ophthalmol, Alicante, Spain
Vissum Inst Oftalmol Alicante, Cornea Cataract & Refract Surg Unit, Grp Miranza, Alicante, Spain
del Barrio, J:
Univ Miguel Hernandez Univ, Div Ophthalmol, Alicante, Spain
Vissum Inst Oftalmol Alicante, Cornea Cataract & Refract Surg Unit, Grp Miranza, Alicante, Spain
Jawad, K:
Lebaneese Univ Hadath EDST Biotechnol, Opt Gen, Saida, Lebanon
:
Miguel Hernandez Univ, Dept Clin Med, Alicante, Spain
Jawad, Z:
Lebaneese Univ Hadath EDST Biotechnol, Opt Gen, Saida, Lebanon
De Miguel, M:
La Paz Hosp Hlth Res Inst, Cell Engn Lab, IdiPAZ, Madrid, Spain
Makdissy, N:
Lebanese Univ, Fac Sci, GSBT Genom Surveillance & Biotherapy Team, Hadath, Lebanon
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