Human corneal endothelial cell transplantation with nanocomposite gel sheet preserves corneal stability in post-corneal transplant bullous keratopathy: a 16-year follow-up.

IF 1.5 Q4 CELL BIOLOGY
American journal of stem cells Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI:10.62347/CBYH7014
Periasamy Parikumar, Kazutoshi Haraguchi, Rajappa Senthilkumar, Samuel Jk Abraham
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Abstract

Post-corneal transplantation endothelial decompensation and subsequent bullous keratopathy often result in unfavorable clinical outcomes regardless of the treatment strategy employed. In this report, we present the outcomes of a patient managed with in vitro expanded human corneal endothelial cell (HCEC) transplantation facilitated by a nanocomposite gel (NC gel) sheet over 16 years. A 40-year-old male patient who presented with signs of graft failure after penetrating keratoplasty underwent HCEC transplantation. Additionally, HCECs were obtained from a deceased donor, cultured in vitro, and transplanted onto an NC gel sheet as a temporary scaffold to support the transplanted cells until engraftment. At the 16-year follow-up, the cornea had remained stable and did not exhibit active disease manifestations. Notably, no new bullae were formed, and the epithelial surface appeared smooth without signs of active fluid transport abnormalities. Although a slight reduction in corneal thickness was observed, the disease-free region at the time of the intervention remained transparent. HCEC transplantation with NC gel sheets is a promising, minimally invasive approach for achieving long-term corneal stability in cases of bullous keratopathy following corneal graft failure. Importantly, this technique circumvents the need for complex procedures and utilizes corneal endothelial precursors derived from donor corneas discarded for lack of sufficient endothelial cells. After in vitro culture, these cells were successfully transplanted in three patients, proving that one donated eye can be useful in treating three eyes of three patients. This technique addresses the donor cornea shortage concerns and makes our concept "an-eye-for-eyes", a reality.

用纳米复合凝胶片移植人角膜内皮细胞可保持角膜移植后大疱性角膜病的角膜稳定性:16 年随访。
角膜移植后内皮失代偿和随后的大疱性角膜病通常会导致不利的临床结果,无论采用何种治疗策略。在本报告中,我们介绍了一名患者在纳米复合凝胶(NC 凝胶)薄片的帮助下,通过体外扩增人角膜内皮细胞(HCEC)移植治疗 16 年后的结果。一名 40 岁的男性患者在穿透性角膜移植术后出现移植失败迹象,于是接受了 HCEC 移植手术。此外,我们还从一名已故捐赠者那里获得了高促性红细胞生成素,经体外培养后移植到 NC 凝胶片上作为临时支架,以支持移植细胞直至其吸收。在 16 年的随访中,角膜一直保持稳定,没有出现活动性疾病表现。值得注意的是,角膜上没有形成新的鼓泡,上皮表面光滑,没有液体运输异常的迹象。虽然观察到角膜厚度略有下降,但干预时的无病区域仍然是透明的。对于角膜移植失败后出现的大疱性角膜病,使用 NC 凝胶片移植 HCEC 是一种很有前景的微创方法,可实现角膜的长期稳定。重要的是,这项技术避免了复杂的手术过程,利用的角膜内皮前体来自因缺乏足够内皮细胞而被丢弃的供体角膜。经过体外培养,这些细胞成功移植到三名患者体内,证明了一只捐献的眼睛可以用于治疗三名患者的三只眼睛。这项技术解决了供体角膜短缺的问题,使我们的 "以眼换眼 "理念成为现实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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