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M. Goel, N. Sharma, R. Tandon, J. S. Titiyal, R. B. Vajpayee; Evaluation of Umbilical Cord Serum Therapy in Acute Ocular Chemical Burns. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4778.
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To evaluate the role of umbilical cord serum therapy in restoration of ocular surface following acute ocular chemical burns.
A double masked prospective randomized controlled clinical study was done in 33 eyes of 32 patients. Patients with ocular chemical burns of grade III, IV, V severity (Dua’s classification) and those presenting within three weeks of injury were recruited. Eyes were randomized into three groups, group one received 20% umbilical cord serum therapy (12 eyes), group two received 20% autologous serum therapy (11 eyes) and group three received artificial tear substitutes (0.5%HPMC+0.3%Glycerin) (10 eyes). In addition all the three groups received standard medical therapy. Pain score, size and area of epithelial defect, extent of limbal ischemia, corneal clarity, tear film break up time (TBUT) and symblepharon formation were assessed on initiation of therapy and on follow up visits at days1, 3, 7, 14, 21 & at the end of 1st, 2nd and 3rd month.
By day 7, patients on cord serum therapy showed significant reduction in pain as compared to autologous serum therapy and placebo therapy (P=0.01). Mean time to complete epithelialisation was 21.2±26.8, 56.6±35.5, and 40.1±35.8 days in cord serum, autologous serum and placebo group respectively (P=0.02). By day 21, the mean percentage decrease in epithelial defect diameter was 94.6±11.9 in cord serum group as compared to 53.2±34.8 & 64.2±42.4 in autologous serum and placebo group respectively (P=0.01). By 3rd month the extent of limbal ischemia in cord serum group had shown a mean percentage decrease of 73.4±25.5 as compared to 35.6±25.6 & 43.7±28.7 in autologous serum and placebo group respectively (P=0.008). By 3rd month 9 out of 12 patients had corneal clarity of grade 4 in umbilical cord serum group as compared to 1 out of 11 and 3 out of 10 in autologous serum and placebo group respectively (P=0.048). TBUT showed statistically significant improvement in cord serum group as compared to the other two groups (P=0.016). No statistically significant difference was seen between the groups with regard to symblepharon formation. None of the patients reported any side effects with either treatment.
20% Umbilical cord serum therapy is more effective in restoration of ocular surface after acute chemical injuries as compared to 20% autologous serum eye drops or artificial tear substitutes (0.5%HPMC+0.3% Glycerin).
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