{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:14:08Z","timestamp":1793301248118,"version":"4.5.0"},"reference-count":39,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T00:00:00Z","timestamp":1698883200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Japanese Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"crossref","award":["22H03244"],"award-info":[{"award-number":["22H03244"]}],"id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["AMED, JP23ek0109572h0003"],"award-info":[{"award-number":["AMED, JP23ek0109572h0003"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Japanese Ministry of Health, Labor, and Welfare","award":["23FC1038"],"award-info":[{"award-number":["23FC1038"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2023,10,9]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>To provide the long-term outcome of patients with end-stage severe ocular surface disease (OSD) consecutively treated with cultivated oral mucosal epithelial transplantation (COMET) followed by limbal-rigid contact lens (CL)-wear therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 23 eyes of 18 patients with severe OSD who underwent COMET surgery between 2002 and 2019 and who were followed with limbal-rigid CL-wear therapy for at least 1\u2009year postoperative, patient demographics, best-corrected visual acuity (BCVA, logMAR), Ocular Surface Grading Scores (OSGS), surgical indication and adverse events were reviewed. Primary and secondary outcomes were BCVA and OSGS changes at baseline and final examination, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study involved 16 patients with Stevens-Johnson syndrome and 2 patients with mucous membrane pemphigoid (mean age: 59\u00b115 years). The indications for COMET were as follows: corneal reconstruction for vision improvement (10 eyes (43.5%)), corneal reconstruction for persistent epithelial defect (4 eyes (17.4%)) and conjunctival (fornix) reconstruction for symblepharon release (9 eyes (39.1%)). The mean duration of CL-wear postsurgery was 6.4\u00b13.9 years (range: 1.4 to 13.3 years). The mean BCVA at baseline and at final follow-up was logMAR 1.9\u00b10.5\u2009and 1.3\u00b10.7, respectively (p&lt;0.05). Compared with those at baseline, the OSGSs for symblepharon and upper and lower fornix shortening showed significant improvement at each follow-up time point post treatment initiation. No serious intraoperative or postoperative adverse events were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients afflicted with severe OSD, COMET combined with limbal-rigid CL-wear therapy postsurgery was found effective for vision improvement and ocular surface stabilisation.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bjo-2023-323617","type":"journal-article","created":{"date-parts":[[2023,11,2]],"date-time":"2023-11-02T17:20:59Z","timestamp":1698945659000},"page":"1177-1183","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Strategic combination of cultivated oral mucosal epithelial transplantation and postoperative limbal-rigid contact lens-wear for end-stage ocular surface disease: a retrospective cohort study"],"prefix":"10.1136","volume":"108","author":[{"given":"Yulia","family":"Aziza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kojiro","family":"Imai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motohiro","family":"Itoi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hokoru","family":"Yoshioka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4208-8966","authenticated-orcid":false,"given":"Seitaro","family":"Komai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2203-5776","authenticated-orcid":false,"given":"Koji","family":"Kitazawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratna","family":"Sitompul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2678-5024","authenticated-orcid":false,"given":"Mayumi","family":"Ueta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Fukuoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Inatomi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6839-251X","authenticated-orcid":false,"given":"Shigeru","family":"Kinoshita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6536-9701","authenticated-orcid":false,"given":"Chie","family":"Sotozono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,11,2]]},"reference":[{"key":"2024072308350678000_108.8.1177.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjophth-2018-000164","article-title":"Twenty years of limbal epithelial therapy: an update on managing limbal stem cell deficiency","volume":"3","author":"Fernandez-Buenaga","year":"2018","journal-title":"BMJ Open Ophthalmol"},{"key":"2024072308350678000_108.8.1177.2","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1001\/jamaophthalmol.2020.1120","article-title":"Outcomes of limbal stem cell transplant: a meta-analysis","volume":"138","author":"Le","year":"2020","journal-title":"JAMA Ophthalmol"},{"key":"2024072308350678000_108.8.1177.3","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.clae.2019.04.006","article-title":"Recovering vision in corneal epithelial stem cell deficient eyes","volume":"42","author":"Bains","year":"2019","journal-title":"Cont Lens Anterior Eye"},{"key":"2024072308350678000_108.8.1177.4","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2003.038497"},{"key":"2024072308350678000_108.8.1177.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.07.053"},{"key":"2024072308350678000_108.8.1177.6","doi-asserted-by":"crossref","first-page":"S19","DOI":"10.1097\/ICO.0000000000002566","article-title":"Oral mucosal epithelial transplantation and limbal-rigid contact lens: a therapeutic modality for the treatment of severe ocular surface disorders","volume":"39 Suppl 1","author":"Sotozono","year":"2020","journal-title":"Cornea"},{"key":"2024072308350678000_108.8.1177.7","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s10561-016-9575-4","article-title":"Long-term result of autologous cultivated oral mucosal epithelial transplantation for severe ocular surface disease","volume":"17","author":"Prabhasawat","year":"2016","journal-title":"Cell Tissue Bank"},{"key":"2024072308350678000_108.8.1177.8","doi-asserted-by":"publisher","DOI":"10.1097\/00003226-200310001-00011"},{"key":"2024072308350678000_108.8.1177.9","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ajo.2020.08.022","article-title":"Outcomes of cultivated oral mucosal epithelial transplantation in eyes with chronic Stevens-Johnson syndrome sequelae","volume":"222","author":"Venugopal","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"2024072308350678000_108.8.1177.10","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2020-318547"},{"key":"2024072308350678000_108.8.1177.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2006.10.029"},{"key":"2024072308350678000_108.8.1177.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2006.06.004"},{"key":"2024072308350678000_108.8.1177.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2014.08.015"},{"key":"2024072308350678000_108.8.1177.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2014.03.012"},{"key":"2024072308350678000_108.8.1177.15","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.ajo.2014.07.012","article-title":"Tear exchangeable limbal rigid contact lens for ocular sequelae resulting from Stevens-Johnson syndrome or toxic epidermal necrolysis","volume":"158","author":"Sotozono","year":"2014","journal-title":"Am J Ophthalmol"},{"key":"2024072308350678000_108.8.1177.16","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1016\/j.clae.2020.05.007","article-title":"Clinical trial to evaluate the therapeutic benefits of limbal-supported contact lens wear for ocular sequelae due to Stevens-Johnson syndrome\/toxic epidermal necrolysis","volume":"43","author":"Itoi","year":"2020","journal-title":"Cont Lens Anterior Eye"},{"key":"2024072308350678000_108.8.1177.17","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/ICL.0000000000000989","article-title":"Long-term benefits of tear exchangeable limbal-rigid contact lens wear therapy in Stevens-Johnson syndrome cases","volume":"49","author":"Yoshikawa","year":"2023","journal-title":"Eye Contact Lens"},{"key":"2024072308350678000_108.8.1177.18","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1038\/eye.2015.3","article-title":"The royal college of ophthalmologists\u2019 national ophthalmology database study of cataract surgery: report 1, visual outcomes and complications","volume":"29","author":"Day","year":"2015","journal-title":"Eye (Lond)"},{"key":"2024072308350678000_108.8.1177.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"2024072308350678000_108.8.1177.20","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1097\/ICO.0000000000002263","article-title":"Long-term progression of ocular surface disease in Stevens-Johnson syndrome and toxic epidermal necrolysis","volume":"39","author":"Yoshikawa","year":"2020","journal-title":"Cornea"},{"key":"2024072308350678000_108.8.1177.21","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/ICL.0000000000000924","article-title":"Limbal-rigid contact lens wear for the treatment of ocular surface disorders: a review","volume":"48","author":"Aziza","year":"2022","journal-title":"Eye Contact Lens"},{"key":"2024072308350678000_108.8.1177.22","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(02)00960-0"},{"key":"2024072308350678000_108.8.1177.23","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.jtos.2016.02.001","article-title":"Acute and chronic ophthalmic involvement in Stevens-Johnson syndrome\/toxic epidermal necrolysis - A comprehensive review and guide to therapy. II. Ophthalmic disease","volume":"14","author":"Kohanim","year":"2016","journal-title":"Ocul Surf"},{"key":"2024072308350678000_108.8.1177.24","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1097\/ICO.0000000000000680","article-title":"Treatment modalities and clinical outcomes in ocular sequelae of Stevens-Johnson syndrome over 25 years-a paradigm shift","volume":"35","author":"Iyer","year":"2016","journal-title":"Cornea"},{"key":"2024072308350678000_108.8.1177.25","doi-asserted-by":"crossref","first-page":"620","DOI":"10.4103\/ijo.IJO_22_18","article-title":"Keratoprosthesis: current global scenario and a broad Indian perspective","volume":"66","author":"Iyer","year":"2018","journal-title":"Indian J Ophthalmol"},{"key":"2024072308350678000_108.8.1177.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2007.11.002"},{"key":"2024072308350678000_108.8.1177.27","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.123.10.1319"},{"key":"2024072308350678000_108.8.1177.28","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1016\/j.survophthal.2022.01.005","article-title":"The historical development and an overview of contemporary keratoprostheses","volume":"67","author":"Moshirfar","year":"2022","journal-title":"Surv Ophthalmol"},{"key":"2024072308350678000_108.8.1177.29","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1097\/ICO.0000000000002098","article-title":"Systematic review and meta-analysis of the medium-and long-term outcomes of the Boston type 1 Keratoprosthesis","volume":"38","author":"Priddy","year":"2019","journal-title":"Cornea"},{"key":"2024072308350678000_108.8.1177.30","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.ajo.2020.07.006","article-title":"Lid-related keratopathy in Stevens-Johnson syndrome: natural course and impact of therapeutic interventions in children and adults","volume":"219","author":"Shanbhag","year":"2020","journal-title":"Am J Ophthalmol"},{"key":"2024072308350678000_108.8.1177.31","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.ajo.2018.01.028","article-title":"Chronic ocular sequelae of Stevens-Johnson syndrome in children: long-term impact of appropriate therapy on natural history of disease","volume":"189","author":"Basu","year":"2018","journal-title":"Am J Ophthalmol"},{"key":"2024072308350678000_108.8.1177.32","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2010.188714"},{"key":"2024072308350678000_108.8.1177.33","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajoc.2022.101473","article-title":"Challenges in the management of bilateral eyelid closure in Stevens-Johnson syndrome","volume":"26","author":"Aziza","year":"2022","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2024072308350678000_108.8.1177.34","doi-asserted-by":"publisher","DOI":"10.1097\/01.ICL.0000152492.98553.8D"},{"key":"2024072308350678000_108.8.1177.35","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-014-2568-8"},{"key":"2024072308350678000_108.8.1177.36","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.ajoc.2018.02.010","article-title":"Improvement of chronic corneal opacity in ocular surface disease with prosthetic replacement of the ocular surface ecosystem (prose) treatment","volume":"10","author":"Cressey","year":"2018","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2024072308350678000_108.8.1177.37","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajoc.2022.101520","article-title":"Regression of corneal opacity and neovascularization in Stevens-Johnson syndrome and toxic epidermal necrolysis with the use of prosthetic replacement of the ocular surface ecosystem (PROSE) treatment","volume":"26","author":"Liao","year":"2022","journal-title":"Am J Ophthalmol Case Rep"},{"key":"2024072308350678000_108.8.1177.38","doi-asserted-by":"crossref","first-page":"101528","DOI":"10.1016\/j.clae.2021.101528","article-title":"Clinical outcomes and complications of fluid-filled Scleral lens devices for the management of limbal stem cell deficiency","volume":"46","author":"Bonnet","year":"2023","journal-title":"Cont Lens Anterior Eye"},{"key":"2024072308350678000_108.8.1177.39","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/j.jtos.2016.06.003","article-title":"Contact lens-induced limbal stem cell deficiency","volume":"14","author":"Rossen","year":"2016","journal-title":"Ocul Surf"}],"container-title":["British Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bjo-2023-323617","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T15:36:03Z","timestamp":1721748963000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjo.bmj.com\/lookup\/doi\/10.1136\/bjo-2023-323617"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,2]]},"references-count":39,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,7,23]]},"published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1136\/bjo-2023-323617"],"URL":"https:\/\/doi.org\/10.1136\/bjo-2023-323617","relation":{},"ISSN":["0007-1161","1468-2079"],"issn-type":[{"value":"0007-1161","type":"print"},{"value":"1468-2079","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,2]]}}}