title: Comparison of Amniotic Membrane Transplantation and Umbilical Cord Serum in Acute Ocular Chemical Burns: A Randomized Controlled Trial.
abstract: OBJECTIVE
  To compare the efficacy of topical umbilical cord serum drops (UCS) and amniotic membrane transplantation (AMT) in acute ocular chemical burns.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  setting: Tertiary care hospital.
  
  
  METHODS
  Forty-five eyes with acute chemical burns of grade III, IV, and V (Dua's classification) presenting within the first week of injury were randomized into 3 groups (15 each). Patients with perforation/impending corneal perforation were excluded from the study.
  
  
  METHODS
  Groups 1, 2, and 3 received UCS with medical therapy (MT), AMT with MT, and MT alone, respectively.
  
  
  METHODS
  Time to complete epithelialization.
  
  
  RESULTS
  The mean time to complete epithelialization was 56.7 ± 14.9, 22.0 ± 10.2, and 22.9 ± 10.1 days in MT, AMT, and UCS groups, respectively, with a significant difference between MT and AMT (P = .001) and between MT and UCS (P = .001), but not between UCS and AMT (P = .9). Improvement in pain score was better with UCS than AMT (P value: .012, .002, and .012 on days 7, 14, and 21, respectively). Corneal clarity was better in the UCS group at 21 (P = .008) and 30 days (P = .002), but not at 3 months (P = .9). By month 3, visual outcome, symblepharon, tear film status, and lid abnormalities were comparable between the 3 groups.
  
  
  CONCLUSIONS
  UCS and AMT, as an adjuvant to standard medical therapy in acute chemical injury, are equally efficacious. UCS has the advantage of faster improvement in corneal clarity, better pain control, and avoidance of surgery in an inflamed eye.
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. Electronic address: namrata.sharma@gmail.com.
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: Divya
authors.initials: D
authors.lastname: Singh
authors.affiliation: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Prafulla K
authors.initials: PK
authors.lastname: Maharana
authors.affiliation: Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Alka
authors.initials: A
authors.lastname: Kriplani
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: Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ravindra Mohan
authors.initials: RM
authors.lastname: Pandey
authors.affiliation: Vision Eye Institute, Royal Victorian Eye and Ear Hospital, North West Academic Centre, University of Melbourne, Melbourne, Australia.
authors.forename: Rasik B
authors.initials: RB
authors.lastname: Vajpayee
mesh_terms: D000293:Adolescent; D000328:Adult; D000650:Amnion / Q000637:transplantation*; D000704:Analysis of Variance; D002057:Burns, Chemical / Q000628:therapy*; D002648:Child; D003316:Corneal Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy; D019573:Epithelium, Corneal; D005126:Eye Burns / Q000139:chemically induced / Q000628:therapy*; D005260:Female; D005312:Fetal Blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D014470:Umbilical Cord; D014792:Visual Acuity; D055815:Young Adult