Retinal Degeneration Clinical Trial
Official title:
Effectiveness and Safety of Subtenon Administration of Autologous Adipose-Derived Regenerative Cells for Treatment of Glaucomatous Neurodegeneration
Autologous adipose-derived regenerative cells (ADRC) extracted using Celution 800/CRS System (Cytori Therapeutics Inc) from a portion of the fat harvested from the patient's front abdominal wall. ADRC will be administered one-time into subtenon space of patient's eyeball. This is a single arm study with no control. All patients receive cell therapy.
Fat tissue obtainment:
Subjects will undergo liposuction under local anesthesia. In this procedure, Ringer's
solution with the anesthetic lidocaine and vasoconstrictor adrenaline infused into the
adipose compartment to minimize blood loss and contamination of the tissue by peripheral
blood cells. 15 minutes later a hollow blunt-tipped 3 mm cannula introduced into the
subcutaneous space through small (0.5 cm) incision. The cannula attached to syringe and under
gentle suction moved through the adipose compartment, mechanically disrupting the fat tissue.
Aspirate volume - approximately 150-200 cc. Procedure time - 30 minutes.
ADRC isolation:
Aspirated fat tissue placed into sterile vessel which inserted into Celution 800/CRS System
(Cytori Therapeutics Inc) - closed system for automated and standardized extraction and
concentration of ADRC. Celution 800/CRS System drains excess of fluid from fat tissue and
estimate it's volume After that lipoaspirate washed extensively with equal volumes of
Ringer's solution to remove blood. At the end of this process System indicates required
volume of enzyme reagent (Celase®) which should be added immediately by operator. After
enzyme treatment Celution 800/CRS System automatically transfers isolated ADRC into washing
compartment where ADRC washed and concentrated in 5 mL suspension. Tissue processing time -
approximately 60 minutes. ADRC suspension match all requirements listed in technical
documentation for Celution 800/CRS System. Obtained ADRC divided into 2 portions. First
portion (0.2-0.5 mL) used for counting, viability and sterility assessment. Second portion
placed into sterile syringe for injection.
Subtenon injection of ADRC:
Antiseptic and anesthetic solutions instilled into conjunctival sac. After that blepharostat
installed. The patient is asked to look in opposite to the injection side direction. Doctor
inserts a needle into inferior temporal quadrant between rectus muscles,10-12 mm from the
limbus. Needle should be moved slowly, as close as possible to the eyeball. After needle
placement at the depth of 5-7 mm doctor injects concentrated solution of ADRC (up to 0,5 ml
per single injection). Injection is made by insulin syringe with a needle size 0.45 mm * 12mm
(26 G).
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