title: Evaluation of the Role of Umbilical Cord Serum and Autologous Serum Therapy in Reepithelialization After Keratoplasty: A Randomized Controlled Clinical Trial.
abstract: OBJECTIVE
  To evaluate the role of umbilical cord serum (UCS) and autologous serum (AS) therapy in reepithelialization of corneal graft after keratoplasty in a randomized controlled trial.
  
  
  METHODS
  A total of 105 eyes with epithelial defect (ED) after keratoplasty (penetrating keratoplasty-67 and anterior lamellar keratoplasty-38) on the first postoperative day were included in the study. The eyes were randomized into three groups: UCS (n=35), AS (n=35), and artificial tears (AT) (n=35). All patients received standard postoperative medical therapy. The primary outcome measure was time to epithelialization, and secondary outcome measures were best-corrected visual acuity and graft clarity.
  
  
  RESULTS
  The ED healed completely in 103 eyes. The mean time for complete reepithelialization was 2.5±2.1, 3.1±2.2, and 4.5±1.4 days in UCS, AS, and AT groups, respectively. The mean percentage decrease in the size of the ED was significantly better in the UCS and AS groups as compared with the AT group (P=0.001). The rate of reepithelialization was comparable between the AS and UCS groups (P=0.3). On bivariate analysis, significant correlation was found between the mean size of postoperative ED, grade of the donor cornea (P=0.001), and the presence of preoperative ED (P=0.001). No complications were associated with the use of serum therapy.
  
  
  CONCLUSIONS
  Most of the cases of postkeratoplasty corneal ED can be managed with AT only. The serum therapy (AS/UCS) helps in the faster reepithelialization of postkeratoplasty ED as compared with AT and may be considered as a treatment option for early epithelial healing.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences (N.K., N.S., P.B., R.N., T.A., T.V.), All India Institute of Medical Sciences, New Delhi, India; Department of Ophthalmology (P.K.M.), All India Institute of Medical Sciences, Bhopal, India; Department of Obstetrics and Gynecology (S.M.), All India Institute of Medical Sciences, New Delhi, India; and Vision Eye Institute, Royal Victorian Eye and Ear Hospital (R.B.V.), North West Academic Centre, University of Melbourne, Australia.
authors.forename: Neha
authors.initials: N
authors.lastname: Kamble
authors.forename: Namrata
authors.initials: N
authors.lastname: Sharma
authors.forename: Prafulla K
authors.initials: PK
authors.lastname: Maharana
authors.forename: Pooja
authors.initials: P
authors.lastname: Bandivadekar
authors.forename: Ritu
authors.initials: R
authors.lastname: Nagpal
authors.forename: Tushar
authors.initials: T
authors.lastname: Agarwal
authors.forename: Thirumurthy
authors.initials: T
authors.lastname: Velpandian
authors.forename: Suneeta
authors.initials: S
authors.lastname: Mittal
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000328:Adult; D003316:Corneal Diseases / Q000601:surgery; D019573:Epithelium, Corneal / Q000502:physiology*; D005260:Female; D005312:Fetal Blood / Q000502:physiology*; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D062326:Re-Epithelialization; D044967:Serum / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology; D014945:Wound Healing / Q000502:physiology