24.06.2017 change 14.11.2017

Pioneering stem cell transplantation to burned eye in Katowice

Photo: Fotolia Photo: Fotolia

Poland\'s first transplantations of stem cells of corneal epithelium in patients with damaged ocular surface after slaked lime burns have been performed by specialists from the Department of Ophthalmology of the Medical University of Silesia.

They have confirmed the high effectiveness of this method - in patients with an initial visual acuity of 10%, visual acuity increased to 50-70% of the original value. Katowice department, operating since 2015 at the Katowice District Railway Hospital, is one of the 17 centres participating in the international Holocore project; this was possible due to many years of experience of this centre in the research on stem cells of corneal epithelium.

It is the only place in Poland and our part of Europe, where patients selected for the procedure can benefit from stem cell therapy with stem cells collected from the other, healthy eye, and cultured in a specialized laboratory in Modena, Italy.

"This method was developed because the previous ones did not meet our expectations. It is a unique procedure - we transplant a drug containing the patient\'s stem cells" - explained the head of department Prof. Edward Wylęgała at the press conference in Katowice on Tuesday. He emphasised that compared to the previously used methods, this method of eye burn treatment is less invasive and brings very good results.

He noted that the procedure is very complicated. Patient must have one healthy eye - from that eye transplant material is taken in a biopsy according to a strictly defined protocol. Then it is placed on a special carrier and transported under special conditions to Italy, where it is cultured for 6 months. "The procedure itself is also very complicated. We have to follow the protocol precisely, watch places where we can not touch the tissue with a knife, we have to do it using special spatulas, microscopes. Transplantation is difficult, we do not sew it, we have to hide it under the conjunctiva" - added Prof. Wylęgała.

The team is planning to perform 10 transplants in adults and 2 in children in the first phase. The department is already the leader in the Holocore project, with two completed transplants and five patients whose biopsy material is in the culturing phase.

The first results of the treatment can be seen after four days, and the final effect can be assessed after a month. Postoperative evaluation includes parameters such as epithelial continuity, corneal vascularization, limbal stem cell deficiency severity parameters, quality of life analysis, final visual acuity and patient safety.

"This is a final phase study - the product is already on the market, approved for patients who have suffered burn injuries, the effectiveness of this method has been proven. Our research will determine its long-term effectiveness, among other things" - said Dr. Dariusz Dobrowolski.

Recently, Dr. Dobrowolski performed the world\'s first corneal epithelial stem cell collection in a child, and in about four months he will perform the first transplantation of cultured corneal epithelium in such a young patient. This patient is a 9 years old Kuba, who was burned with slaked lime during a home renovation. A bucket with slaked lime was outside, and the child was playing in the sandbox. He took some slaked lime into his toy bucket, from which the toxic substance splashed into the eye, causing a very serious burn.

"The doctor gave us a lot of hope that he would see normally, the same as his peers. Right now he can;t see at all. We are told that there is a good chance that he will see like before the accident. At first, no one gave us any chance that Kuba would ever see with that eye" - said his father Grzegorz Barański.

Zdzisław Tomczyk from Międzyborza, who underwent the procedure on Thursday, is also awaiting the effects of the transplantation. "I can see better now, earlier I could see up to 20 cm, now up to 2 m" - he told PAP.

Anna Gumułka (PAP)

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