Experience in personalized cell therapy clinical implementation for treatment of patients with primary endothelial dystrophy after phacoemulsification

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Abstract

The article presents treatment results of the personalized cell therapy (PCT) method in patients with early post-operative bullous keratopathy which developed in eyes with pre-existing primary Fuchs’ corneal endothelial dystrophy (ED). The patented PCT consists in incubating in vitro the patient’s blood with the stimulator (polyA:polyU), collecting serum with activated leukocytes weighted in it, and introducing the obtained cell preparation in the anterior chamber of the patient’s eye. The study included 12 patients with ED and pseudophakia. The observation period ranged from 8 to 12 months. The therapeutic effect of PCT was obtained in 58.3% of cases, allowing to avoid further surgical procedures. To achieve a good therapeutic effect, several PCT sessions are recommended. To date, PCT is the only effective therapeutic treatment method for early corneal edema after phacoemulsification.

About the authors

Sergey Yu. Astakhov

Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russia

Author for correspondence.
Email: astakhov73@mail.ru

MD, PhD, DMedSc, professor, head of the department. Ophthalmology Department

Russian Federation, Saint Petersburg

Inna A. Riks

Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: riks0503@yandex.ru

MD, PhD, assistant. Ophthalmology department

Russian Federation, Saint Petersburg

Sanasar S. Papanyan

Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: dr.papanyan@yandex.ru

MD, aspirant. Ophthalmology department

Russian Federation, Saint Petersburg

Arkadiy A. Kasparov

Research Institute of Eye Diseases

Email: kasparov17@mail.ru

DMedSc, professor, head of corneal pathology department

Russian Federation, Moscow

Evgeniya A. Kasparova

Research Institute of Eye Diseases

Email: kasparova_jane@mail.ru

PhD, senior research assistant. Corneal pathology department

Russian Federation, Moscow

Aleksandr S. Pavlyuk

Pirogov Russian National Research Medical University

Email: treg4@yandex.ru

DMedSc, professor. Immunology department

Russian Federation, Moscow

Karolina Fedotova

Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: karo-luna@mail.ru

Aspirant. Ophthalmology department

Russian Federation, Saint Petersburg

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2. Fig. 1. Patient G.: a — before personalized cell therapy — pronounced edema of stroma, coarse folds of DM, density of endothelial cells is not reliably determined. Visual acuity is 0.1; b — 7 days after personalized cell therapy: reduction of edema of the stroma, restoration of the transparency of the cornea and a decrease in the number of folds of the DM (expansion ≈ 70% of the folds of the DM). Visual acuity — 0,3

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3. Fig. 2. Patient N.: a — before personalized cell therapy: pronounced diffuse edema of stroma in the center of the cornea, single bullae, tender folds of DM, endothelial cell density is not reliably determined. Visual acuity is 0.1; b — 7 days after personalized cell therapy: resorption of edema of the stroma in the optical center, but in the paracentral zone the site of the local edema of the stroma is preserved, the corneal transparency is restored, there are no folds. Visual acuity — 0,4; c — endothelial microscopy. The density of endothelial cells after 7 days is 1729 cells/mm2, polymegatism — 62.8%, pleomorphism — 28.5%

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4. Fig. 3. Patient M.: a — before personalized cell therapy: moderately pronounced edema of the endothelium. The density of endothelial cells is not reliably determined, visual acuity is 0.01; b — 14 days after personalized cell therapy: decrease edema of the endothelium, restore the transparency of the cornea, no folds DM. Visual acuity is 0.4, endothelial cell density is 1600 cells/mm2; c — 4 months after the 2nd session of personalized cell therapy: persistent edema of the endothelium, visual acuity — 0.7, density of endothelial cells — 1612 cells/mm2

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Copyright (c) 2017 Astakhov S.Y., Riks I.A., Papanyan S.S., Kasparov A.A., Kasparova E.A., Pavlyuk A.S., Fedotova K.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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