RT Journal Article
SR Electronic
T1 Comparison of umbilical cord serum and amniotic membrane transplantation in acute ocular chemical burns
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 669
OP 673
DO 10.1136/bjophthalmol-2014-305760
VO 99
IS 5
A1 Namrata Sharma
A1 Shiv Shankar Lathi
A1 Sri Vatsa Sehra
A1 Tushar Agarwal
A1 Rajesh Sinha
A1 Jeewan S Titiyal
A1 Thirumurthy Velpandian
A1 Radhika Tandon
A1 Rasik B Vajpayee
YR 2015
UL http://bjo.bmj.com/content/99/5/669.abstract
AB Purpose To compare the efficacy of umbilical cord serum (UCS) with amniotic membrane transplantation (AMT) in cases of acute ocular chemical burns. Methods In a retrospective, interventional, comparative case series, 55 eyes with grades III, IV and V chemical burns (Dua's classification) who presented within 3 weeks of injury were evaluated. Patients were treated with conventional medical (CM group, 20 eyes) management alone or combined with either UCS (UCS group, 17 eyes) or AMT (AMT group, 18 eyes). The parameters evaluated were time to epithelialisation, epithelial defect diameter, epithelial defect area, corneal clarity, tear break-up time (TBUT), Schirmer test and best-corrected vision. Results UCS and AMT groups showed early epithelialisation as compared with the CM group (Kaplan–Meier analysis=0.01). Mean time for healing of epithelial defect was 57.7±29.3, 27.4±19.0, 41.1±28.9 days in the CM, UCS and AMT groups, respectively (p=0.02). Mean TBUT at the last follow-up was 8.6±0.7, 10.3±1.1, 9.4±1.2 s in the CM, UCS and AMT groups, respectively (p=0.02). The mean Schirmer value at the last follow-up was 13.7±1.0, 16.9±3.0 and 13.2±1.5 mm in the CM, UCS and AMT groups, respectively (p=0.01). The visual outcomes and the occurrence of corneal vascularisation, symblepheron, ectropion and entropion were comparable in between the groups. Conclusions Our study suggests that the UCS therapy may be a better alternative to AMT in acute moderate to severe (grades III, IV and V) ocular chemical burns, as it avoids surgical manoeuvre in already inflamed eyes.