# Management of Intraocular Pressure Elevation After Commercially Available Cultivated Oral Mucosal Epithelial Cell Transplantation for Limbal Stem Cell Deficiency

## TL;DR

This study found that a cell transplant treatment for eye stem cell deficiency causes a temporary rise in eye pressure, which is usually manageable with medication or additional procedures.

## Contribution

The study reports on IOP elevation after commercially available COMET in Japanese LSCD patients and its management.

## Key findings

- IOP significantly increased one day and one week after COMET surgery.
- One patient required cyclophotocoagulation due to uncontrolled IOP.
- Most IOP elevation cases were managed with eye drops.

## Abstract

Purpose: This study aimed to examine the changes in intraocular pressure (IOP) after commercially available cultivated oral mucosal epithelial cell transplantation (COMET) in Japanese patients with limbal stem cell deficiency (LSCD).

Methods: This retrospective observational study included consecutive patients who underwent commercially available COMET (Ocural®, Japan Tissue Engineering Co., Ltd. (J-TEC), Tokyo, Japan, and Nidek Co., Ltd., Gamagori, Japan) for LSCD at the University of Tokyo Hospital from January to December 2023. Their medical charts were reviewed for background information, IOP measurements, medication use, and surgery for IOP elevation before and one day, one week, one month, three months, and six months after COMET and the final follow-up point.

Results: Nine eyes from nine patients (mean age: 59.7±12.4 years) were included in the study. The primary diseases associated with LSCD were chemical burns (three eyes), Stevens-Johnson syndrome (two eyes), congenital aniridia (two eyes), and others (two eyes). IOP was significantly elevated from 9.7±4.1 mmHg before surgery to 23.0±12.3 mmHg one day after surgery (p=0.008) and to 20.2±7.0 mmHg one week after surgery (p=0.006). IOP was uncontrollable with eye drops in one eye (11.1%) two weeks after surgery, necessitating three sessions of micropulse transscleral cyclophotocoagulation. The mean number of antiglaucoma medications used did not change significantly during the observation period.

Conclusion: Commercially available COMET induces IOP elevation during the early postoperative period. Most cases of IOP elevation can be controlled with adequate management, but some instances of uncontrolled IOP necessitate careful consideration.