Cornea - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaMethods: Lacrimal glands were removed from wildtype rats andmice. One part of the tissue was used for cell culture, the other partwas embedded for immunostaining. Cultivated cells and lacrimalgland tissue was evaluated for the expression of mesenchymalprogenitor cell markers, such as, nestin, thy 1, PDGFR-β, CD146,SMA, desmin, vimentin, GFAP, musashi-1, CD34 and pancytokeratin.Results: Cells expanded from lacrimal gland tissue explants showeda fibroblast-like cell shape and noticeable intracellular lipid droplets.After eight days of culture a subpopulation of cells showed signs ofdifferentiation into myofibroblasts by demonstrating typical stressfibers. Expression of mesenchymal stem cell markers thy-1, PDGFRβ,SMA, desmin and vimentin, musashi-1 and CD146 wasdemonstrated by immunostaining. Cells appeared to be negative forCD34. Furthermore cells positive for GFAP and nestin could bedetected in lacrimal gland tissue sections.Conclusions: Murine and rat lacrimal gland cells can be successfullyisolated and expanded in vitro using explant culture techniques. Theoutgrowing cell population shows characteristics of mesenchymalstem cells, however more studies are needed to evaluate thedifferentiation potential and regenerative ability of this cellpopulation.Commercial Relationships: Mathias Roth, None; AlexanderKunze, None; Gerd Geerling, Alcon (C), Allergan (C), TheaPharma (C), Novagali (C), Bausch & Lomb (C), Tearlab Inc. (C);Stefan Schrader, NoneProgram Number: 5425 Poster Board Number: A0124Presentation Time: 8:30 AM - 10:15 AMLong-Term Outcomes of Patients with Ocular Surface Stem CellTransplant: 20 years follow-upKunal Suri, Stephen C. Kaufman. Ophthalmology and VisualNeurosciences, University of Minnesota, Minneapolis, MN.Purpose: To evaluate the long-term outcomes and complications ofocular surface stem cell transplant (OSST).Methods: A retrospective observational case series of patients whohad OSST at the University of Minnesota Medical Center between1990 to 2000, performed by a single surgeon. Patients with minimumone-year follow-up after surgery were included. Demographic data,indication for surgery, further procedures, success rates,complications, duration of immunosuppression, and follow-up timewere recorded.Results: There were a total of 20 eyes of 15 patients with mean age48.8 ± 15.9 years (25-86 years) at the time of surgery. There were60% males and 33% had bilateral surgery. The indication for surgerywas chemical injury in 8 eyes (40%), aniridia in 7 eyes (35%),iatrogenic limbal stem cell deficiency (LSCD) in 2 eyes (10%),Sjögren’s syndrome in 2 eyes (10%) and Stevens-Johnson Syndrome(SJS) in 1 eye (5%). Total keratolimbal allograft (KLAL) wasperformed in 80% eyes (16/20), sectoral KLAL in 15% eyes (3/20)and conjunctival limbal allograft (CLAL) in 5% eyes (1/20).Glaucoma was associated pre-operatively in 55% eyes. Five eyes hadprevious keratoplasty and 2 eyes had keratoplasty with OSST. Meantime to keratoplasty after OSST was 12.6±16.2 months (2.5-57months). Repeat keratoplasty was required in 70.5% of eyes (12/17).Mean number of keratoplasties required after OSST was 1.95±1.3 (0-5). Mean follow-up was 148±59.1 months (19-251 months) and meanduration of systemic immunosuppression was 107.6±60.3 (6-186)months in 14 eyes. Stable ocular surface was seen in 66.6% eyes(2/3) after sectoral KLAL, 23.1% eyes (3/13) after total KLAL onsystemic immunosuppressive therapy and 33% eyes (1/3) after totalKLAL without systemic immunosuppressive therapy. At last visit,10% eyes (2/20) had had Boston Keratoprosthesis (K-Pro) surgery.Repeat OSST was required in 30% eyes (6/20). Complicationsincluded recurrent epithelial defect in 14 eyes (70%), one or moreepisodes of graft rejection in 13 eyes (65%), increased intraocularpressure that required placement of tube shunt in 9 eyes (45%),infectious keratitis in 5 eyes (25%) and descemetocele in 2 eyes(10%).Conclusions: Long-term follow-up after total OSST with systemicimmunosuppression showed graft failure in 77% eyes. Multipleocular surgeries were required in 70% eyes. Recurrent epithelialdefect was the most common complication occurring in 70% eyes.Commercial Relationships: Kunal Suri, None; Stephen C.Kaufman, IOP (C)Support: Unrestricted grant from Research to Prevent BlindnessProgram Number: 5426 Poster Board Number: A0125Presentation Time: 8:30 AM - 10:15 AMMild-moderate dry eye patients exhibit ocular surfacetemperature lower than normal subjectsgiuseppe giannaccare, Piera Versura, Marco Grillini, Emilio C.Campos. Ophthalmology Unit, DIMES Department, Alma MaterStudiorum University of Bologna and S.Orsola-Malpighi TeachingHospital, Bologna, Italy.Purpose: To measure ocular surface temperature (OST) in mildmoderatedry eye (DE) patients and to correlate values with diseaseseverityMethods: 30 patients diagnosed as having mild-moderate DEaccording to DEWS guidelines (DEWS grade 1 and 2, 15 patientseach) and 30 normal subjects were included in this prospectivecontrolled study. Exclusion criteria were: history of atopy, allergicdiseases, infectious surface diseases, chemical/thermal injury.Dynamic infrared non-contact thermal imaging (Tomey TG 1000,Nagoya, Japan; Emmeciquattro, Parma, Italy) was used to measureOST in 3 circular (4 mm diameter) regions: central cornea (CC),nasal conjunctiva (NC) and temporal conjunctiva (TC). Theprocedure was repeated 3 times during a single session by 2examiners. OST was measured immediately after blinking at eyeopening (T0) and after 10 second of sustained eye opening (T1); thedifference between the two values (Δ) was calculated. Discomfortsubjective symptoms were evaluated with OSDI questionnaire.Schirmer test I, Break up Time (BUT), Lissamine green vitalstaining, conjunctival scraping cytology and determination ofexudated serum albumin in tears were performed in all subjects. OSTand Δ values recorded in all regions were correlated (Pearson’s r)with the tests. Data were statistically evaluated by applying Student’st test, Mann-Whitney and Wilcoxon’s tests, when appropriate,significance p