title: Comparison of umbilical cord serum and amniotic membrane transplantation in acute ocular chemical burns.
abstract: OBJECTIVE
  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.
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shiv Shankar
authors.initials: SS
authors.lastname: Lathi
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sri Vatsa
authors.initials: SV
authors.lastname: Sehra
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sinha
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Jeewan S
authors.initials: JS
authors.lastname: Titiyal
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Thirumurthy
authors.initials: T
authors.lastname: Velpandian
authors.affiliation: Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Radhika
authors.initials: R
authors.lastname: Tandon
authors.affiliation: Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000208:Acute Disease; D000328:Adult; D000650:Amnion / Q000637:transplantation*; D002057:Burns, Chemical / Q000209:etiology / Q000628:therapy*; D003316:Corneal Diseases / Q000209:etiology / Q000628:therapy*; D003318:Corneal Opacity / Q000175:diagnosis; D019573:Epithelium, Corneal / Q000473:pathology; D005126:Eye Burns / Q000139:chemically induced*; D005260:Female; D005312:Fetal Blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013666:Tears / Q000378:metabolism; D014470:Umbilical Cord; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
keywords: Cornea; Treatment Medical; Treatment Surgery