Cornea - I Free Papers - aioseducation

Cornea Free Papers
Persistent epithelial defect (PED) is defined as a corneal epithelial defect of
2mm or larger in its greatest dimension persisting for 2 weeks or more despite
of conventional treatment with artificial tears or bandage contact lens usage.
It can be caused by keratoconjunctivitis sicca, exposure keratitis, neurotrophic
keratits, limbal stem cell failure, keratoplasty, chemical burns and corneal
ulcers. It has been seen that deficiency of essential tears components such
as epidermal growth factors (EGF), vitamin A,neurotrophic growth factors
(NGF) such as substance P, acetylcholine may exacerbate the lesions. Umbilical
cord serum which contains various growth factors, Vitamin A and fibronectin
in high concentration is hypothesized as a potent option for the treatment of
persistent epithelial defects resistant to other conventional therapy. This study
is aimed to evaluate the efficacy and safety of umbilical cord serum in cases of
persistent epithelial defects due to various causes.
(1) To study the efficacy and safety of topical umbilical cord serum in persistent
corneal epithelial defects. (2) To study the complications encountered (3) To
study the rate of recurrence.
MATERIALS AND METHODS
Study Design
Prospective, non comparative study, Study population: 20 eyes of 20 patients
with persistent corneal epithelial defects were selected from routine OPD of a
tertiary care centre. Patients were followed for a period of 6 months from the
day of starting the topical umbilical cord serum eye drops.
Inclusion Criteria
Patients of any age group, preferably cooperative for digital photography, were
included with PED of various etiopathogenesis e.g., Chemical burn, Diabetic
neurotrophic ulcer, Bacterial ulcer. Herpetic neurotrophic ulcer, Keratoplasty
(optical and therapeutic), Dry Eye.
Exclusion Criteria
Patients with the following conditions were excluded: Pregnant and lactating
women, Immunological conditions like rheumatoid arthritis, active corneal
ulcer, impending perforation, acute ocular infection, abnormality of eyelid
and adenexa eg – trichiasis, blepharitis, ectropion, entropion. Processing Of
Umbilical Cord serum: Umbilical cord blood was collected from mothers of
uncomplicated caesarean deliveries after informed consent and screening for
hepatitis B, C and HIV. No anticoagulants were used during the procedure.
The blood was allowed to clot and was centrifuged at 1500 rpm for 5 min then
diluted in normal saline to make 20% solution. The serum was stored at -4
degrees C. This diluted umbilical cord serum was stored in 5 ml sterilized
vials and was given to patients. Patients were to apply this serum in drop 6
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