Download fulltext
HTML
1.
Moradian S, Ebrahimi M, Kanaani A, Faramarzi A, Safi S. Topical Umbilical Cord Serum for Corneal Epithelial Defects after Diabetic Vitrectomy. JOVR [Internet]. 2020Apr.6 [cited 2024Apr.25];15(2):160–165. Available from: https://knepublishing.com/index.php/JOVR/article/view/6732
https://doi.org/10.18502/jovr.v15i2.6732
statistics
- 733 Abstract Views
- 392 PDF Views
- 0 HTML Views
authors
-
Siamak Moradian
Siamak Moradian
Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Marzieh Ebrahimi
Marzieh Ebrahimi
Department of Stem Cells, Cell Science Research Center, Royan Institute, Tehran, Iran
-
Azade Kanaani
Azade Kanaani
Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Amir Faramarzi
Amir Faramarzi
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
-
Sare Safi
Sare Safi
Ophthalmic Epidemiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Published Date
- Apr 6, 2020
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.
Keywords:
Corneal Epithelial Defect, Diabetic Vitrectomy, Topical Umbilical Cord Serum
References
1. Bright Bill FS, Myers FL, Bresnick G. Post vitrectomy keratopathy. Am J Ophthalmol 1978;85:651–655.
2. Foulds GN, Thoft RA, Perry HD, Tolentino FI. Factors related to corneal complications after closed vitrectomy in diabetics. Arch Ophthalmol 1979;97:1076–1077.
3. Yoon KC, Im SK, Park YG, Jung YD, Yang SY, Choi J. Application of umbilical cord serum eye drops for the treatment of dry eye syndrome. Cornea 2006;25:268–272.
4. Yoon KC, Heo H, Im SK, You IC, Kim YH, Park YG . Comparison of autologous serum and umbilical cord serum eye drops for dry eye syndrome. Am J Ophthalmol 2007;144:86–29.
5. Yoon KC, Heo H, Jeong IY, Park YG. Therapeutic effect of umbilical cord serum eye drops for persistent epithelial defect. Korean J Ophthalmol 2005;19:174–178.
6. Bright Bill FS, Myers FL, Bresnick GH. Post vitrectomy keratopathy. Am J Ophthalmol 1978;85:651–655.
7. Fribery TR, Doran DL, Lazenby FL. The effect of vitreous and retinal surgery on corneal endothelial cell density. Ophthalmology 1984;91:1166–1169.
8. Virata SR, Kylstra JA, Singh HT. Corneal epithelial defects following vitrectomy surgery using hand–held, sew-on, and noncontact viewing lenses. Retina 1999;19:287–290.
9. Friberg TR, Ohji M, Scherer JJ, Tano Y. Frequency of epithelial debridement during diabetic vitrectomy. Am J Ophthalmol 2003;135:552–554.
10. Oyakawa RT, Schachat AP, Michels RG, Rice TA. Complications of vitreous surgery for diabetic retinopathy: I. Intraoperative complications. Ophthalmology 1983;90:517–521.
11. Chung H, Tolentino FI, Cagita VN, A losta J Refojo MF. Reevaluation of corneal complications after closed vitrectomy. Arch Ophthalmol 1988;106:916–919.
12. Cisarik-Fredenburg P. Discoveries in research on diabetic keratopathy. Optomery 2001;72:691–704.
13. Brazzell RK, Stern ME, Aquavella JV, Beuerman RW, Baird L. Human recombinant epidermal growth factor in experimental corneal wound healing. Invest Ophthalmol Vis Sci 1991;32:339–340.
14. Schultz GS, Chegimini N, Grant M, Khaw P, Mackay A. Effect of growth factors on corneal wound healing. Arch Ophthalmol 1992:70:60–66.
15. Maldorado BA, Furcht LT. Epidermal growth factor stimulates integrin-mediated cell migration of cultured human corneal epithelial cells on fibronectin and arginineglycerine- aspartic acid peptide. Invest Ophthalmol Vis Sci 1995;36:2120–2126.
16. David T, Rieck P, Renard G, Hartmann C, Courtois Y, Pouliquen Y. Corneal wound healing modulation using basic fibroblast growth factor after excimer laser photorefractive keratectomy. Cornea 1995;14:227–234.
17. Nishida T, Nakamura M, Mishiana H, Otori T, Hikida M. Intreleukin 6 facilitates corneal epithelial wound closure in vivo. Arch Ophthalmol 1992;110:1292–1294.
18. Ohji M, Mandarinol, Sundar Raj N, Thoft RA. Corneal epithelial cell attachment with endogenous laminin and fibronectin. Invest Ophthalmol Vis Sci 1993;34:2487–2492.
19. Nakamura M, Nishida I, Hikida M, Otori T. Combined effects of hyalophane and fibronectin on corneal epithelial wound closure of rabbit in vivo. Curr Eye Res 1994;13:385–388.
20. Maldonado BA, Furcht LT. Involvement of integrins with adhesion promoting, heparin- binding peptides of type IV collagen in cultured human corneal epithelial cells. Invest Ophthalmol Vis Sci 195;36:364–372.
21. Nishida T, Nakamura M, Ofuji K, Reid TW, Manoes MJ, Murphy GJ. Synergistic effects of substance p with insulinlike growth factor-1 on epithelial migration of the cornea. J Cell Physiol 1990;169:159–166.
22. Nokamura M, Ofujik, Chikama T, Nishida. Combined effects of substance P and insulin- like growth factor-1 on corneal epithelial would closure of rabbit in vivo. Curr Eye Res 1997;16:275–278.
23. Tan MH, Bryars J .Use of nerve growth to treat congenital neurotrophic corneal ulceration .Cornea 2006;25:b352–b355.
24. Bonni S, Lambiase A, Rama P, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for neurotrophic keratitis. Ophthalmology 2000;107:1347–1351.
25. Lambiase A, Rama P, Bonni S, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for corneal neurotrophic ulcers. N Eng J Med 1998;338:1174–1180.
26. Ohashi Y, Motokura M, Kinoshita Y, Mano T, Watanabe H, Kinoshita S, et al. Presence of epidermal growth factor in human tears. Invest Ophthalmol Vis Sci 1989;30:1879–1887.
27. Van Setten G, Teno T, Tervo K, Tarkkanen A. Epidermal growth factor (EGF) in ocular fluid: presence, origin and therapeutic consideration. Acta Ophthalmol 1992;202:54–59.
28. Dua HS, Gomes JA, Singh A. Corneal epithelial wound healing. Br J Ophthalmol 1994:78;401–408.
29. Geerling G, Maclennan S, Hartwing D. Autologous serum eye drops for ocular surface disorders. Br J Ophthalmol 2004;88:1467–1474.
30. Tsubota K, Goto E, Shimmura S, Shimazaki J. Treatment of persistent corneal epithelial defect by autologous serum applications. Ophthalmology 1999;106:1984–1987.
31. Nobel BA, Loh RSK, Maclennan S, Pesudovs K, Reynolds A, Bridges LR, et al. Comparison of autologous serum eye drops with conventional therapy in a randomized controlled crossover trial for ocular surface disease. Br J Ophthalmol 2004:88:647–652.
32. Fox RI, Chan R, Michelson J, Belmont JB, Michelson PE. Beneficial effect of artificial tears made with autologous serum in patients with keratoconjunctivitis sica. Arthritis Rheum 1984;27:456–461.
33. Poon AC, Geerling G, Dart JK, Fraenkel GE, Daniels JT. Autologus serum eye drops for dry eyes and epithelial defects: clinical and in vitro toxi city studies. Br J Ophthalmol 2007;85:1188–1197.
34. Tananuvat N, Daniell M, Sullivan LJ, Yi Q, McKelvie P, McCarty DJ. Controlled study of the use of use of autologous serum in dry eye patients. Cornea 2001;20:802–806.
35. Goto E, Shimmura S, Shimazski J, Tsubota K. Treatment of superior Limbic kerato conjunctivitis by application of autologous serum. Cornea 2001;20:807–810.
36. Matsumoto Y, Dogru M, Goto E, Ohashi Y, Kojima T, Ishida R, et al. Autologous serum application in the treatment of neurotrophic keratopathy. Ophthalmology 2004;111:1115–1120.
37. Vajpayee RB, Mukerji N, Tandon R, Sharma N, Pandey RM, Biswas NR, et al. Evaluation of umbilical cord serum therapy for persistent corneal epithelial defects. Br J Ophthalmol 2003;87:1312–1316.
2. Foulds GN, Thoft RA, Perry HD, Tolentino FI. Factors related to corneal complications after closed vitrectomy in diabetics. Arch Ophthalmol 1979;97:1076–1077.
3. Yoon KC, Im SK, Park YG, Jung YD, Yang SY, Choi J. Application of umbilical cord serum eye drops for the treatment of dry eye syndrome. Cornea 2006;25:268–272.
4. Yoon KC, Heo H, Im SK, You IC, Kim YH, Park YG . Comparison of autologous serum and umbilical cord serum eye drops for dry eye syndrome. Am J Ophthalmol 2007;144:86–29.
5. Yoon KC, Heo H, Jeong IY, Park YG. Therapeutic effect of umbilical cord serum eye drops for persistent epithelial defect. Korean J Ophthalmol 2005;19:174–178.
6. Bright Bill FS, Myers FL, Bresnick GH. Post vitrectomy keratopathy. Am J Ophthalmol 1978;85:651–655.
7. Fribery TR, Doran DL, Lazenby FL. The effect of vitreous and retinal surgery on corneal endothelial cell density. Ophthalmology 1984;91:1166–1169.
8. Virata SR, Kylstra JA, Singh HT. Corneal epithelial defects following vitrectomy surgery using hand–held, sew-on, and noncontact viewing lenses. Retina 1999;19:287–290.
9. Friberg TR, Ohji M, Scherer JJ, Tano Y. Frequency of epithelial debridement during diabetic vitrectomy. Am J Ophthalmol 2003;135:552–554.
10. Oyakawa RT, Schachat AP, Michels RG, Rice TA. Complications of vitreous surgery for diabetic retinopathy: I. Intraoperative complications. Ophthalmology 1983;90:517–521.
11. Chung H, Tolentino FI, Cagita VN, A losta J Refojo MF. Reevaluation of corneal complications after closed vitrectomy. Arch Ophthalmol 1988;106:916–919.
12. Cisarik-Fredenburg P. Discoveries in research on diabetic keratopathy. Optomery 2001;72:691–704.
13. Brazzell RK, Stern ME, Aquavella JV, Beuerman RW, Baird L. Human recombinant epidermal growth factor in experimental corneal wound healing. Invest Ophthalmol Vis Sci 1991;32:339–340.
14. Schultz GS, Chegimini N, Grant M, Khaw P, Mackay A. Effect of growth factors on corneal wound healing. Arch Ophthalmol 1992:70:60–66.
15. Maldorado BA, Furcht LT. Epidermal growth factor stimulates integrin-mediated cell migration of cultured human corneal epithelial cells on fibronectin and arginineglycerine- aspartic acid peptide. Invest Ophthalmol Vis Sci 1995;36:2120–2126.
16. David T, Rieck P, Renard G, Hartmann C, Courtois Y, Pouliquen Y. Corneal wound healing modulation using basic fibroblast growth factor after excimer laser photorefractive keratectomy. Cornea 1995;14:227–234.
17. Nishida T, Nakamura M, Mishiana H, Otori T, Hikida M. Intreleukin 6 facilitates corneal epithelial wound closure in vivo. Arch Ophthalmol 1992;110:1292–1294.
18. Ohji M, Mandarinol, Sundar Raj N, Thoft RA. Corneal epithelial cell attachment with endogenous laminin and fibronectin. Invest Ophthalmol Vis Sci 1993;34:2487–2492.
19. Nakamura M, Nishida I, Hikida M, Otori T. Combined effects of hyalophane and fibronectin on corneal epithelial wound closure of rabbit in vivo. Curr Eye Res 1994;13:385–388.
20. Maldonado BA, Furcht LT. Involvement of integrins with adhesion promoting, heparin- binding peptides of type IV collagen in cultured human corneal epithelial cells. Invest Ophthalmol Vis Sci 195;36:364–372.
21. Nishida T, Nakamura M, Ofuji K, Reid TW, Manoes MJ, Murphy GJ. Synergistic effects of substance p with insulinlike growth factor-1 on epithelial migration of the cornea. J Cell Physiol 1990;169:159–166.
22. Nokamura M, Ofujik, Chikama T, Nishida. Combined effects of substance P and insulin- like growth factor-1 on corneal epithelial would closure of rabbit in vivo. Curr Eye Res 1997;16:275–278.
23. Tan MH, Bryars J .Use of nerve growth to treat congenital neurotrophic corneal ulceration .Cornea 2006;25:b352–b355.
24. Bonni S, Lambiase A, Rama P, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for neurotrophic keratitis. Ophthalmology 2000;107:1347–1351.
25. Lambiase A, Rama P, Bonni S, Caprioglio G, Aloe L. Topical treatment with nerve growth factor for corneal neurotrophic ulcers. N Eng J Med 1998;338:1174–1180.
26. Ohashi Y, Motokura M, Kinoshita Y, Mano T, Watanabe H, Kinoshita S, et al. Presence of epidermal growth factor in human tears. Invest Ophthalmol Vis Sci 1989;30:1879–1887.
27. Van Setten G, Teno T, Tervo K, Tarkkanen A. Epidermal growth factor (EGF) in ocular fluid: presence, origin and therapeutic consideration. Acta Ophthalmol 1992;202:54–59.
28. Dua HS, Gomes JA, Singh A. Corneal epithelial wound healing. Br J Ophthalmol 1994:78;401–408.
29. Geerling G, Maclennan S, Hartwing D. Autologous serum eye drops for ocular surface disorders. Br J Ophthalmol 2004;88:1467–1474.
30. Tsubota K, Goto E, Shimmura S, Shimazaki J. Treatment of persistent corneal epithelial defect by autologous serum applications. Ophthalmology 1999;106:1984–1987.
31. Nobel BA, Loh RSK, Maclennan S, Pesudovs K, Reynolds A, Bridges LR, et al. Comparison of autologous serum eye drops with conventional therapy in a randomized controlled crossover trial for ocular surface disease. Br J Ophthalmol 2004:88:647–652.
32. Fox RI, Chan R, Michelson J, Belmont JB, Michelson PE. Beneficial effect of artificial tears made with autologous serum in patients with keratoconjunctivitis sica. Arthritis Rheum 1984;27:456–461.
33. Poon AC, Geerling G, Dart JK, Fraenkel GE, Daniels JT. Autologus serum eye drops for dry eyes and epithelial defects: clinical and in vitro toxi city studies. Br J Ophthalmol 2007;85:1188–1197.
34. Tananuvat N, Daniell M, Sullivan LJ, Yi Q, McKelvie P, McCarty DJ. Controlled study of the use of use of autologous serum in dry eye patients. Cornea 2001;20:802–806.
35. Goto E, Shimmura S, Shimazski J, Tsubota K. Treatment of superior Limbic kerato conjunctivitis by application of autologous serum. Cornea 2001;20:807–810.
36. Matsumoto Y, Dogru M, Goto E, Ohashi Y, Kojima T, Ishida R, et al. Autologous serum application in the treatment of neurotrophic keratopathy. Ophthalmology 2004;111:1115–1120.
37. Vajpayee RB, Mukerji N, Tandon R, Sharma N, Pandey RM, Biswas NR, et al. Evaluation of umbilical cord serum therapy for persistent corneal epithelial defects. Br J Ophthalmol 2003;87:1312–1316.