autologous cultivated oral mucosal epithelial sheets

Autologous cultivated oral mucosal epithelial sheets (COMES) are a cell-based therapy developed by Siriraj Hospital for the treatment of bilateral limbal stem cell deficiency (LSCD). The procedure involves harvesting a small biopsy of the patient's own oral mucosal tissue, which is then cultivated ex vivo on a scaffold—typically using irradiated J2 fibroblast feeder cells—for approximately 14 days to form a stratified epithelial sheet. This sheet is then transplanted onto the patient's damaged cornea to restore the ocular surface, improve corneal transparency, and enhance visual acuity. This approach is specifically designed for patients with bilateral LSCD, such as those resulting from chemical burns or Stevens-Johnson Syndrome, where autologous limbal stem cell grafts are unavailable because both eyes are affected.

Other names

COMESautologous oral mucosal epithelial sheet transplantationcultivated oral mucosal epithelial transplantation