Personalized cell-based therapy in ophthalmology. III. Clinical efficacy in the treatment of corneal endothelial diseases

Abstract

Severe lesions of corneal endothelium usually lead to progressing corneal oedema, sharp decrease in visual acuity and as a result to the need for transplanting donor cornea that can provoke relevant sequelae, thus an active search for alternative impacts to the affected cell layer is underway allowing for keeping out of operative intervention. The purpose of this research is to evaluate the clinical efficacy of a method of personalized cell therapy (aqueous chamber administration of suspension consists of activated autologous leukocytes in serum) aimed to treatment of early postoperative bullous keratopathy and severe form of herpetic keratoiridocyclitis. The results of clinical application of personalized cell therapy in 210 patients with postoperative bullous keratopathy (60) and herpetic keratoiridocyclitis (150) - divided into 2 subgroups: 75 patients received personalized cell therapy (experimental subgroup), the other 75 patients were injected intracamerally with a solution of poludan preparation (control subgroup), are presented in the article. The pronounced therapeutic effect in the treatment of early postoperative bullous keratopathy was achieved in 44 % of cases, with an increase in visual acuity of 0,49±0,27. Straightening of the descemet membrane's folds, significant dehydration of corneal stroma and complete restoration of corneal transparency, a reduction in the thickness of the cornea from 801±112 pm to 582±55 pm have been achieved. In the group of herpetic keratoiridocyclitis treatment, recovery was achieved in 85 % - complete resorption of corneal infiltration and edema and restoration of corneal transparency. The increase in visual acuity in this group was 0,6±0,3. The normalization of the corneal structure after personalized cell-based therapy is also evidenced by in vivo confocal microscopy data. The correlation of the clinical effect with the concentration in the cellular preparation of TNF-α, IL-6 and IL-1 was established. Personalized cell therapy is effective method of curative action on damaged corneal endothelium that does not require keratoplasty.