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Rasik Behari Vajpayee, Neha Kamble, Namrata Sharma, Tushar Agarwal, Thirumurthy Velpandian, Suneeta Mittal; Evaluation of Umbilical Cord Serum Therapy in Re-epithelialization of the Corneal Graft after Keratoplasty. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1509.
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To evaluate the efficacy of cord serum therapy in re-epithelialization of the graft after corneal transplantation surgery as compared to standard medical treatment alone.
One hundred and five eyes of 105 patients, who underwent optical keratoplasty and had epithelial defect on first post-operative day, received umbilical cord serum eyedrops (n=35), autologous serum eyedrops (n=35) or artificial tears (0.5% HPMC+ 0.3% glycerine; n=35). In addition, all eyes received standard post operative treatment. The parameters evaluated were time to epithelialization, uncorrected visual acuity and graft clarity.
Distribution of patients in terms of age, gender, laterality, indication, donor age, death-to-preservation time and grade of donor cornea was comparable in three groups. Most common indication for optical penetrating keratoplasty was leucomatous corneal opacity and for lamellar keratoplasty was keratoconus. The epithelial defect healed completely in 103 eyes. The mean time for complete re-epitheliaization was 2.5 ± 2.1 days, 3.1 ± 2.2 days and 4.5 ± 1.4 days in cord serum, autologous serum and artificial tear group, respectively. The mean percentage decrease in the size of the epithelial defect was significantly greater in the cord serum group and autologous serum group as compared to artificial tear group (p = 0.001). However, the rate of re-epithelialization was comparable between autologous serum and cord serum group (p = 0.3). No significant difference in the improvement in visual acuity (p = 0.29) and in graft clarity (p = 0.8) between groups was found. In bivariate analysis, significant correlation was found between mean size of post-operative epithelial defect and DET (p=0.002), grade of donor cornea (p = 0.001) and presence of pre-operative epithelial defect (p = 0.001). No significant complications associated with serum use were observed.
Both umbilical cord serum and autologous serum result in faster re-epithelialization of post keratoplasty epithelial defect as compared to artificial tears. However, no significant difference was found in graft re-epthelialization between autologous serum and cord serum.
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