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Topical Umbilical Cord Serum for Corneal Epithelial Defects after Diabetic Vitrectomy.

ABSTRACT: Purpose:To evaluate the role of topical umbilical cord serum (TUCS) therapy in treating corneal epithelial defects (CEDs) after diabetic vitrectomy. Methods:In this double-masked, randomized clinical trial, we included 80 eyes of 80 patients who were candidates for vitrectomy due to proliferative diabetic retinopathy complications. In cases of corneal edema obscuring the fundus view during surgery, the corneal epithelium was removed using a 6-mm trephine and a blade no.15. The day after the surgery, patients were randomly divided into two groups: (1) the TUCS group that received 20% TUCS six times/day in addition to the conventional treatment of CED and (2) the control group, which was prescribed artificial tears as placebo in addition to the conventional treatment of CED. The rate of healing of CEDs was measured via two maximum linear dimensions perpendicular to each other at the start of therapy and on postoperative days 1-5, 7, and 12. Results:Of 80 eyes, 40 were assigned to each treatment group. The mean times to complete CED healing were 2.4 ± 0.7 and 3.8 ± 2.1 days in the TUCS and control groups, respectively (P < 0.001). Persistent CED occurred in two eyes in the control group but in no eyes in the TUCS group. Conclusion:TUCS therapy may be safe and effective in healing CEDs after vitrectomy in patients with diabetes.

SUBMITTER: Moradian S

PROVIDER: S-EPMC7151505 | biostudies-literature | 2020 Apr-Jun

REPOSITORIES: biostudies-literature

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Topical Umbilical Cord Serum for Corneal Epithelial Defects after Diabetic Vitrectomy.

Moradian Siamak S Ebrahimi Marzieh M Kanaani Azade A Faramarzi Amir A Safi Sare S

Journal of ophthalmic & vision research 20200406 2

<h4>Purpose</h4>To evaluate the role of topical umbilical cord serum (TUCS) therapy in treating corneal epithelial defects (CEDs) after diabetic vitrectomy.<h4>Methods</h4>In this double-masked, randomized clinical trial, we included 80 eyes of 80 patients who were candidates for vitrectomy due to proliferative diabetic retinopathy complications. In cases of corneal edema obscuring the fundus view during surgery, the corneal epithelium was removed using a 6-mm trephine and a blade no.15. The day ...[more]

PMID: 32308949

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Project description:BackgroundHuman autologous serum (AS) and umbilical cord serum (UCS) both contain growth and neurotrophic factors that promote corneal healing.AimOur objectives were to compare equine AS and UCS cytokine and growth factor profiles and to assess the safety and clinical feasibility of the therapeutic use of UCS eye drops in cases of spontaneous complex ulcers.Study designProspective clinical trial.MethodsVitamin A insulin growth factor, platelet-derived growth factor-BB, transforming growth factor (TGF)-β1 (enzyme-linked immunosorbent assay), interleukin (IL)-1β, IL-6, interferon-γ, and monocyte chemoattractant protein 1 concentrations were determined in 10 AS collected from different horses and 10 UCS sampled at delivery. Six client-owned horses presenting with complex non-healing corneal defects of >5 mm2 were included in a clinical trial and treated with conventional therapy and conditioned UCS drops for 8-15 days. Ulcer surface and time to complete epithelialization were recorded.ResultsMedian concentrations of vitamin A, insulin growth factor, and platelet-derived growth factor-BB were not significantly different in AS compared with UCS (respectively, 14.5 vs. 12.05 μg/ml; 107.8 vs. 107.3 pg/ml; and 369.1 vs. 924.2 pg/ml). TGF-β1 median concentration in UCS was significantly higher than in AS (3,245 vs. 2571pg/ml) (p = 0.04). IL-1β, IL-6, interferon-γ, and monocyte chemoattractant protein 1 concentrations were variable in AS and undetectable in UCS. The corneal median ulcerative area was 37.2 mm2 (6.28-57.14 mm2) and had a duration of 4-186 days (median 19 days). All lesions healed within 13-42 days (median 17 days). No adverse effects nor recurrences within 1 month were noticed.LimitationsThe sample size was small. Spontaneous corneal epithelial defects presented with variable clinical characteristics. There were no age-matched control horses to assess corneal healing time and rate.Conclusion and clinical significanceEquine UCS may be beneficial, as it contains no pro-inflammatory cytokines and a greater concentration of TGF-β1 compared with AS. Topical UCS appears safe and may potentially be used as adjunctive therapy for equine complex non-healing ulcers.

Dataset Information

Topical Umbilical Cord Serum for Corneal Epithelial Defects after Diabetic Vitrectomy.

Publications

Topical Umbilical Cord Serum for Corneal Epithelial Defects after Diabetic Vitrectomy.

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