Efficacy of Cultivated Oral Mucosal Epithelial Transplantation for Limbal Stem Cell Deficiency in Stevens–Johnson Syndrome Versus Other Etiologies
Issued Date
2026-01-23
Resource Type
ISSN
02773740
eISSN
15364798
Scopus ID
2-s2.0-105037742575
Pubmed ID
41649359
Journal Title
Cornea
Volume
Publish Ahead of Print
Rights Holder(s)
SCOPUS
Bibliographic Citation
Cornea Vol.Publish Ahead of Print (2026)
Suggested Citation
Ngowyutagon P., Prabhasawat P., Chirapapaisan C., Chotikavanich S., Sikarinkul R., Kengpunpanich S., Taetrongchit N., Setthawong S., Ekpo P., Inthasin N. Efficacy of Cultivated Oral Mucosal Epithelial Transplantation for Limbal Stem Cell Deficiency in Stevens–Johnson Syndrome Versus Other Etiologies. Cornea Vol.Publish Ahead of Print (2026). doi:10.1097/ICO.0000000000004107 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116651
Title
Efficacy of Cultivated Oral Mucosal Epithelial Transplantation for Limbal Stem Cell Deficiency in Stevens–Johnson Syndrome Versus Other Etiologies
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Abstract
PURPOSE: – The aim of this study was to compare the efficacy and outcomes of cultivated oral mucosal epithelial transplantation (COMET) in limbal stem cell deficiency (LSCD) between patients with Stevens–Johnson syndrome (SJS) and those with other etiologies (non-SJS), evaluated by clinical manifestations and epithelial phenotypes.METHODS: – This prospective, comparative study enrolled patients with LSCD who were scheduled for COMET. Preoperative and postoperative assessments were performed using slit-lamp microscopy, in vivo confocal microscopy (IVCM), and impression cytology with immunofluorescence staining. Successful outcomes were defined as an intact ocular surface without conjunctivalization and the presence of cornea-like epithelium detected by IVCM and/or immunofluorescence staining at the central cornea. Otherwise, the outcomes were interpreted as failure. Visual improvement and risk factors of COMET failure were analyzed.RESULTS: – Eighteen eyes of 18 patients (7 with SJS, 11 non-SJS) were included. The median follow-up time was 15.5 months (range: 13–35 months). The overall success rate was 72.2% (13 eyes: 2 with SJS and 11 non-SJS), which was significantly lower in patients with SJS (28.6%) than in non-SJS patients (100%) (P = 0.002). Among successful cases, 60.2% showed visual improvement while the others (30.8%) remained unchanged. The risk of COMET failure was significantly associated with SJS (P = 0.002), lid margin keratinization (P = 0.023), preoperative symblepharon (P = 0.036), postoperative epithelial defects lasting more than 2 weeks (P = 0.022), and the absence of multilayered cornea-like epithelium detected by IVCM at 6 months postoperatively (P = 0.017).CONCLUSIONS: – COMET demonstrates good efficacy and favorable outcomes for LSCD, particularly in non-SJS eyes. While the success rate was excellent in non-SJS patients, the outcomes were significantly limited in those with SJS.