Corneal Burn Research Articles

The Use of Stem Cells in Burn Wound Healing: A Review.

Burn wound healing involves a series of complex processes which are subject to intensive investigations to improve the outcomes, in particular, the healing time and the quality of the scar. Burn injuries, especially severe ones, are proving to have devastating effects on the affected patients. Stem cells have been recently applied in the field to promote superior healing of the wounds. Not only have stem cells been shown to promote better and faster healing of the burn wounds, but also they have decreased the inflammation levels with less scar progression and fibrosis. This review aims to highlight the beneficial therapeutic effect of stem cells in burn wound healing and to discuss the involved pathways and signaling molecules. The review covers various types of burn wound healing like skin and corneal burns, along with the alternative recent therapies being studied in the field of burn wound healing. The current reflection of the attitudes of people regarding the use of stem cells in burn wound healing is also stated.

The Effect of Topical Honey on the Healing of Cornea Following Alkaline Injury and Surgical Abrasions in Rats

Corneal traumatic injury and chemical burn are common types of corneal injury that may lead to persistent ulceration, corneal opacification and angiogenesis. This study aims to assess the therapeutic effects and the underlying mechanisms of topical honey in the healing of cornea after alkaline-induced and surgically induced corneal injury. Sixty albino rats were divided into three equal groups were included: GI: normal control group, GII: alkaline-induced injury group using a 3 mm chemical filter paper soaked in 1 N Na OH, and GIII: surgically induced injury group using PRK spatula to remove corneal surface epithelial layer. Left eyes of rats in GII and GIII groups received honey treatment after injury while right eyes had injury only. Honey was applied five times/day to the left corneas of rats in groups GII and GIII. Assessment of inflammatory changes and healing of corneas were done before scarification using inflammatory index score and fluorescein staining score, respectively. Rats were sacrificed at 24 hours, 48 hours and 7 days after injury. After sacrificing, half number of corneas was used for histopathological assessment and the other half was used for ELISA assessment of VEGF, TGF-β and TNF-α levels in corneal tissue homogenates. There was significant improvement of fluorescein staining score and ulcer healing in both models in honey-treated compared to untreated corneas. Furthermore, in alkaline-induced injury model, inflammatory index score was significantly decreased in honeytreated corneas compared to untreated ones. Regarding histopathology, there was a significant decrease in histological inflammation grade in honey-treated corneas compared to non-treated ones in the alkaline-induced injury model. Finally, ELISA results showed a significant improvement in VEGF, TGF-β and TNF-α level in the two models of corneal injury with more effect in the alkaline-induced injury model. Treatment with honey improved corneal alkaline-induced and surgically-induced abrasions in rats and showed anti-inflammatory and anti-angiogenic properties.

Nanostructured bioplastic material for traumatic corneal injuries

To substantiate the use of nanostructured bioplastic material for the treatment of traumatic eye injuries. The study enrolled 96 eyes of 48 rabbits and was carried out in 3 series of experiments, different in the type of induced corneal trauma: mechanical erosion, alkaline or acid burn. The animals were clinically monitored and sacrificed for morphological investigation at days 3, 7, 14, 30, and 90. The size of mechanical corneal erosions was repeatedly evaluated with fluorescein eye stain test. In the experimental group, Hyamatrix biomaterial was topically administered according to an original technique. In the controls, soft contact lenses were inserted and sutured. Complete closure of the epithelial defect with no impact on corneal properties was achieved in 3 days in the experimental group and in4 days in the control group. As for alkaline and acid corneal burns, experimental and control groups received Hyamatrix biomaterial and Solcoseryl eye gel correspondingly. In the experimental group of alkaline burn the defect closed by day 7, in the controls--by day 10-11. Acid-induced corneal edema also resolved by day 7 in the experimental group and by day 14 in the control group. 1. The results of this experimental and morphological study prove the hyaluronic acid-derived nanostructured bioplastic material effective in accelerating corneal re-epithelialization after mechanical erosions as compared with the controls. 2. Topical application of the hyaluronic acid-derived nanostructured bioplastic material shortens the exudative phase of inflammation, promotes corneal defect closure with formation of a more subtle opacification, and stimulates corneal restoration after chemical burns.

Effect of Allogeneic Limbal Mesenchymal Stem Cell Therapy in Corneal Healing: Role of Administration Route

Aims: To investigate whether allogeneic limbal mesenchymal stem cell (LMSC) therapy affects corneal healing after a severe chemical burn and whether the route of administration of LMSCs differs in its therapeutic effect in this respect. Methods: A total of 60 Sprague-Dawley rats with clinically proven alkali injury were divided into four equal groups (n = 15) as follows: group 1: 2 × 10⁵ cells/drop LMSCs, topically applied 6 times a day for 2 days; group 2: 2.4 × 10⁶ cells in 0.5 ml LMSCs, subconjunctivally applied; group 3: 2.4 × 10⁶ cells in 1 ml LMSCs, intraperitoneally applied, and group 4: no LMSC treatment. The groups were compared according to grades of corneal opacity (CO), corneal neovascularization (CNV) and corneal fluorescein staining (CFS). The migration of LMSCs into the cornea and the inflammatory characteristics of the groups were evaluated with BrdU (5-bromo-2′-deoxyuridine bromodeoxyuridine) immunostaining and histopathologically in a 4-week follow-up. Results: There were statistically significant differences between the LMSC-treated and control groups in each week regarding mean CO scores and in the 3rd week regarding the mean CNV and CFS scores (p < 0.05). The statistical significance was due to the differences between the topical and the control group and between the subconjunctival and the control group. BrdU+ LMSCs were seen in the corneal epithelium of the all LMSC-administered rats, and fewer inflammatory changes were observed in these rats. Conclusion: Allogeneic LMSC treatment, especially topical and subconjunctival administration, seems to be helpful in affecting corneal healing after a severe corneal burn.

Clinical analysis of occupational corneal burns

Objective To study the characteristics and treatment of occupational corneal burns. Methods 85 eyes of 75 patients with corneal bums were analyzed retrospectively. The treatment included topical eye drops, single layer amnion covering or amniotic tamponade according to the scope and depth of corneal injury. All the patients were followed up for 6 months after treatment. Results Corneal healing and visual recovery after injury had close relationship with corneal bums depth： the cornea and vision recovered well when burns involved superficial cornea only; Corneal healing and vision recovery were bad when burns involved deep cornea. In which corneal melt occurred and enucleation of eyeball were perfermed in some cases even after active operation had done. Conclusion Occupational corneal burns in factory is severe and the efficacy of treatment is poor; Prevention is important and it is necessary to supervise and manage all production links. Key words: Bums, corneal ; Melting , corneal; Covering , amnion

Ustione corneale durante intervento di facoemulsificazione: contributo casistico e considerazioni medico-legali

[Corneal burn during phacoemulsification surgery: case report and medico-legal considerations] The authors report a case of severe corneal burn, occured a few seconds later the beginning of the surgical procedure of phacoemulsification on a 63 years old woman affected by cataract. The authors analyzed the case as a result of claims for damage to the surgeons and the hospital by the patient. In terms of assessment of responsibility, medico-legal investigation is aimed at identifying whether the responsibility of the event of damage to the patient is to be attributed to the negligent conduct of the surgeon or to defects or damage to the equipment used by the same. The authors underline the importance of an accurateknowledge of the procedures for using in safety the instrumentation and monitoring the adverse reactions connected to the use of the instrumentation itself, even in the global risk management.

Neovascular growth in an experimental alkali corneal burn model

ObjectiveTo analyze the length and area of corneal surface occupied by vessels, and their location in an experimental model of alkali burn-induced corneal neovascularization. MethodsAn injury to the central cornea of the right eye in 91 Sprague-Dawley rats was induced using a silver nitrate pencil. The rats were divided into seven groups that were sacrificed 2, 4, 6, 8, 10, 12 and 14 days post-injury, and then perfused with a mixture of Chinese ink in PBS (phosphate buffer saline). Corneas were flat-mounted processed and divided into four quadrants. Corneal neovascular growth parameters (length and area) and the location of these vessels were performed blind. The results were statistically analyzed. ResultsNeovascular growth was observed from day 2, reaching its maximum peak in length and area on the 12th day post-injury. A slight reduction in corneal neovascularization was observed after this day. The vessels were initially located in the middle third of the stroma and tended to be observed in the anterior third during the course of the experiment. ConclusionsNeovascularisation was observed on day 2 post-injury in all sectors of corneal surface. Neovascular growth was uniform during the experiment. Neovessels were located in the middle and anterior third of the cornea.

Anti-neovascular effect of chondrocyte-derived extracellular matrix on corneal alkaline burns in rabbits.

We investigated the effect of a chondrocyte-derived extracellular matrix (CDECM) on experimental corneal alkaline burns in rabbits. Corneal neovascularization (NV) was induced by applying an 8-mm filter paper soaked in 1N NaOH to the right central corneas of rabbits for 1minute. Ten days later, the rabbits were randomly divided into three groups: the alkaline burn group, the CDECM transplantation group, and the human amniotic membrane (HAM) transplantation group. The left eyes were used as controls. CDECM and HAM were transplanted onto the corneal surface to completely cover the resected area and were subsequently sutured. On the 10th day after transplantation, the structural changes of the cornea were analyzed histologically. We examined the effects of CDECM on clinical NV features and on the expression of corneal NV markers. The alkaline burn produced significant NV and increased the corneal thickness. On day 10 after transplantation, the thickness, NV and opacity of the cornea were markedly decreased in the CDECM group (p < 0.001). However, the HAM transplantation group did not exhibit improvements in these clinical parameters, and there were no significant differences relative to the burn group. In addition, the use of CDECM improved the healing of the cornea following the alkaline burn by disrupting the corneal epithelial proliferation and reducing the fibrotic changes of the stroma. The hallmarks of NV were significantly induced in the subepithelium by the alkaline burn, and these levels were also suppressed by CDECM. The CDECM suppressed corneal NV by inhibiting nuclear factor-kappa B (NF-κB) activation by blocking the PKC and Akt signaling pathways. CDECM transplantation was markedly effective in healing alkali-burned corneas by modulating the translocation of NF-κB to the nucleus, thereby representing a promising material for the noninvasive treatment of ocular surface disease.

Alkali Burn to the Eye

The aim of this study was to evaluate early retinal damage after induction of ocular surface alkali burns and the protective effects of tumor necrosis factor alpha (TNF-α) blockade. Alkali injury was induced in mouse corneas by using 1 N NaOH. Retinal damage was assessed using a terminal deoxynucleotidyl transferase 2'-deoxyuridine 5-triphosphate nick end labeling (TUNEL) assay, 15 minutes to 14 days postburn. Immune cell infiltration was assessed by CD45 immunolocalization. Retinal cytokines were quantified using the enzyme-linked immunosorbent assay for interleukin (IL)1β, IL2, IL6, TNF-α, CCL5, and macrophage inflammatory protein-1α. Protection against retinal damage was attempted with a single dose of either anti-TNF-α antibody (infliximab, 6.25 mg/kg) or control immunoglobulin G (IgG), administered intraperitoneally 15 minutes after the burn was inflicted. Corneal injury was evaluated by using TUNEL and CD45 immunolocalization and by quantifying corneal neovascularization. There was significant damage to the retina within 24 hours of the corneal burn being inflicted. TUNEL+ labeling was present in 80% of the retinal ganglion cells, including a few CD45+ cells. There was a 10-fold increase in the retinal inflammatory cytokines in the study groups compared with that in controls. A single intraperitoneal dose of anti-TNF-α antibody, administered 15 minutes after the burn, markedly reduced retinal TUNEL+, CD45+ labeling, and inflammatory cytokine expression, compared with that in the controls. Additionally, TNF-α blockade caused a marked reduction in corneal neovascularization, and in cornea TUNEL and CD45 labeling, 5 days after the burn. This study shows that alkali corneal burns can induce significant retinal damage within 24 hours. A single dose of anti-TNF-α antibody, administered 15 minutes after inflicting the burn, provides significant retinal and corneal protection. This could lead to the discovery of novel therapies for patients with alkali injuries.

Peroxynitrite Upregulates Angiogenic Factors VEGF-A, BFGF, and HIF-1α in Human Corneal Limbal Epithelial Cells

Corneal neovascularization (NV) is a sight-threatening condition often associated with infection, inflammation, prolonged contact lens use, corneal burns, and acute corneal graft rejection. Macrophages recruited to the cornea release nitric oxide (NO) and superoxide anion (O2(-)), which react together to form the highly toxic molecule peroxynitrite (ONOO(-)). The role of ONOO(-) in upregulating multiple angiogenic factors in cultured human corneal limbal epithelial (HCLE) cells was investigated. Human corneal limbal epithelial cells were incubated with 500 μM of ONOO(-) donor for various times. VEGF-A, BFGF, and hypoxic-inducible factor-alpha (HIF-1α) were investigated via Western blot and RT-PCR was performed for VEGF. Functional assays using human umbilical vein endothelial cells (HUVEC) used conditioned media from ONOO(-)-exposed HCLE cells. Secreted VEGF from conditioned media was detected and analyzed using ELISA. Increased angiogenic factors were observed as early as 4 hours after HCLE exposure to ONOO(-). HIF-1 expression was seen at 4, 6, and 8 hours post-ONOO(-) exposure (P < 0.05). BFGF expression was elevated at 4 hours and peaked at 8 hours after treatment with ONOO(-) (P < 0.005). Increased VEGF-A gene expression was observed at 6 and 8 hours post-ONOO(-) treatment. Functional assays using conditioned media showed increased HUVEC migration and tube formation. Exposure to elevated extracellular concentrations of ONOO(-) results in upregulation of angiogenic factors in HCLE cells. It is possible that, in the setting of inflammation or infection, that exposure to ONOO(-) could be one contributor to the complex initiators of corneal NV. Validation in vivo would identify an additional potential control point for corneal NV.

Corneal Burn Caused by Carbon Dioxide Ultrapulsed Laser for Nevus Removal

Purpose: Periocular carbon dioxide ultrapulsed laser surgery can induce ocular damage. Herein we report a rare case of corneal burn after carbon dioxide ultrapulsed laser for nevus removal. Case summary: A 25-year-old female patient presented with ocular pain, decreased visual acuity, and metamorphopsia in the left eye after laser surgery for nevus removal at a dermatology clinic 4 days prior. The patient’s best corrected visual acuity in the left eye was 20/100. Central corneal haziness and corneal epithelial defect were observed on biomicroscopic examination. Antibiotics, steroid and artificial tear eye drops were administered for treatment. Glasses were prescribed to correct refraction errors. After 2 months of treatment, the best corrected visual acuity in the left eye recovered to 20/50, and corneal epithelial defect was mostly healed, however corneal haziness remained. Conclusions: Carbon dioxide ultrapulsed laser is commonly used in dermatological treatments. The use of an eye shield is important during this procedure, and possibility of ocular surface damage from laser treatment should be considered. J Korean Ophthalmol Soc 2014;55(9):1376-1379

A Case of Corneal Burn During Phacoemulsification

A Case of Corneal Burn During Phacoemulsification

The changes of anatomic and topographic characteristics of eye anterior segment after uncomplicated cataract phacoemulsification

Aim. To study the changes of anatomic and topographic characteristics of the eye anterior segment after uncomplicated cataract phacoemulsification using corneal incision with intraocular soft lens implantation. Methods. The data of ultrasound biomicroscopy and noncontact tonometry of 58 eyes (56 patients, 32 females, 24 males aged 54 to 78 years) before and after cataract phacoemulsification were analyzed. Paitents with survived ocular trauma, refractive keratoplasty, glaucoma, uveitis, and surgical complications (incomplete capsulorrhexis, posterior capsule rupture, ciliary zonule disinsertion, corneal burn). Apart from the common examinations (visual acuity testing, tonometry, tonography, eye A- and B-ultrasonography, biomicroscopy), all patients underwent eye ultrasound biomicroscopy. Results. Anterior chamber depth increased from 2.73±0.10 to 4.17±0.06 mm (p ≤0.001). Trabecula-iris distance measured at 500 μm from the scleral spur, increased from 0.38±0.02 to 0.47±0.02 mm (p ≤0.001). Anterior chamber angle increased from 28.69±1.87 to 42.73±1.56 degrees (p ≤0.001), the angle between the iris and the sclera increased from 32.78±1.39 to 41.36±0.84 degrees (p ≤0.001), the angle between the sclera and ciliary processes increased from 39.48±1.29 to 45.30±1.16 degrees (p ≤0.001). Intraocular pressure according to the non-contact tonometry data decreased from 18.16±1.29 to 13.55±0.95 mm Hg (p ≤0.001). Conclusion. Anterior chamber depth, trabecula-iris distance, anterior chamber angle, the angle between sclera and iris and the angle between sclera and ciliary processes increased significantly after phacoemulsification with intraocular lens implantation. Intraocular pressure decreased significantly according to the non-contact tonometry data.

Temperature profiles of sleeveless and coaxial phacoemulsification

To study the temperature profile at the corneal wound during 2 sleeveless techniques versus 2 coaxial phacoemulsification techniques. Department of Ophthalmology, Meir Medical Center, Kfar Saba and Ein-Tal Eye Center, Tel-Aviv, Israel. Experimental study. Thirty-six porcine eyes were randomized into 4 groups: Group 1: conventional coaxial system (3.0 mm incision); Group 2: coaxial microincision cataract surgery (MICS) system (2.2 mm incision); Group 3: bimanual MICS (1.1 mm incision); Group 4: sleeveless tri-MICS (1.1 mm incision) using a 19-gauge anterior chamber maintainer as the sole fluid source. Temperature measurements were taken using a thermocouple and an infrared thermal imaging system. Measurements were taken in 2 settings; that is, with and without occlusion. With no occlusion, corneal burns did not occur in any group. However, corneal temperatures were lower with the sleeveless systems (Groups 3 and 4) than with the coaxial systems (Groups 1 and 2) (P=.0003). When occlusion was induced, temperatures were kept constantly low in the sleeveless groups, whereas in the coaxial groups, temperatures increased rapidly, causing corneal burns within seconds. The mean temperature elevations at the incision sites were 39 °C, 48.5 °C, 13.6 °C, and 11.3 °C in Groups 1, 2, 3, and 4, respectively (P<.0001). Sleeveless phacoemulsification maintained lower tissue temperatures than sleeved coaxial methods. During occlusion, fluid flow around the naked tip of the sleeveless systems prevented heat accumulation and corneal burns.

Topical treatment with a new matrix therapy agent (RGTA) in combination with limbal allograft in ocular surface desease and corneal anesthesia

AbstractPurpose The surgical management of limbal deficiency is difficult, especially when it is bilateral and occupies more than half of the cornea. In these advanced cases, the presence of an associate corneal anesthesia, worsen the prognosis of allo‐limbal transplantation. We aimed to assess the efficacy and tolerance of a new matrix therapy agent (RGTA, Cacicol20), mimicking heparan sulfates, in combination with limbal allograft for the reconstruction of the ocular surface with complete corneal anesthesia.Methods It is a prospective, single‐center study. Six eyes of six patients were included. All were men. The average age was 53 years [range : 35‐87]. Mean follow‐up was 4.8 months [range : 3‐9 months]. Etiologies were corneal burn in three cases, an herpes infection in one case and idiopathic in 2 cases. All patients underwent limbal allograft associated with instillation of eye drops RGTA once every two days in the absence of healing after 7 days postoperatively. A topical steroid is prescribed in all cases. RGTA eye drops were stopped after complete healing. Patients were followed every 7 days until healing. Visual acuity, corneal sensitivity and the surface of the ulcer are evaluated each time using photography.Results Despite the persistence of total corneal anesthesia, the epithelium healed in all cases before 2 months [range 7 days to 2 months}. Two of 6 patients showed significant improvement in their visual acuity. One patient had a corneal abscess regressing under treatment.Conclusion RGTA seems to be a potentially useful, alternative, noninvasive therapeutic in association with limbal allograft in advanced limbal deficiency

High-Resolution Spectral Domain Anterior Segment Optical Coherence Tomography in Type 1 Boston Keratoprosthesis

To report the results of imaging using high-resolution, Fourier domain anterior segment optical coherence tomography (AS-OCT) to evaluate patients with a type 1 Boston Keratoprosthesis (KPro). We performed a retrospective comparative study of patients in whom we implanted the Boston KPro. A total of 26 eyes of 23 patients from the Cornea Service at the University of California Davis Eye Center were included. Subjects were evaluated with the Spectralis AS-OCT (Heidelberg Engineering GmbH). Preoperative diagnoses for KPro surgery included failed corneal transplant (69%), chemical burn (23%), and aniridia (8%). The average age of patients was 63.2 years (range, 17-88 years). Fifty-four percent of the patients were female. The mean duration between the KPro surgery and the acquisition of high-resolution AS-OCT imaging was 35.8 months (range, 2-90 months). The most commonly observed finding was retroprosthetic membrane formation, which we found in 77% of KPro eyes. In 65% of KPro eyes, we identified epithelium behind the front plate, and in 54%, we identified an epithelial lip over the anterior surface of the KPro front plate. In 31% of KPro eyes, we identified periprosthetic cysts, gaps or spaces, and thinning in the corneal carrier graft. Fourier domain AS-OCT is a useful noninvasive imaging technique in patients with a KPro and provides the ability to identify changes that are sometimes difficult to appreciate by clinical evaluation. The higher resolution Fourier domain systems may aid in the clinical diagnosis and management of pathology that might not be imaged with instruments of lower resolution. AS-OCT has the potential for monitoring the anatomic stability of an implanted KPro and may also help to monitor for complications. Moreover, high-resolution imaging may enhance our understanding of periprosthetic anatomy.

Comparison of subconjunctivally injected bevacizumab, ranibizumab, and pegaptanib for inhibition of corneal neovascularization in a rat model.

To compare the efficacies of subconjunctival bevacizumab, ranibizumab, and pegaptanib sodium injections for the inhibition of corneal neovascularization in an experimental rat model. Sixteen corneas of 16 rats were chemically cauterized and randomized into four groups: bevacizumab group that treated with 0.05mL/1.25mg bevacizumab, ranibizumab group that treated with 0.05mL/0.5mg ranibizumab, pegaptanib group that treated with 0.05mL/0.15mg pegaptanib sodium, and control group that treated with 0.05mL saline solution. Digital photographs of the corneas were taken and analyzed using an image analysis software program. All corneas were excised and examined histologically on the 15(th) day. Each treatment group had significantly less neovascularized corneal areas and fewer blood vessels than the control group (all P<0.05). In addition, bevacizumab group had significantly less neovascularized corneal areas and fewer blood vessels than ranibizumab and pegaptanib groups (both P<0.05). However, there was no significant difference between the ranibizumab and pegaptanib groups regarding percentage of neovascularized corneal areas and number of blood vessels (both P>0.05). Subconjunctival bevacizumab, ranibizumab, and pegaptanib sodium were effective with no corneal epitheliopathy for inhibiting corneal neovascularization after corneal burn in rats. Bevacizumab was more effective than ranibizumab and pegaptanib sodium.

A Modified Rat Model for Corneal Alkali Burn

The Ormerod et al. (2) animal model is widely accepted and commonly used for corneal alkali burn research. However, although this model is considered the standard for corneal alkali burn, severe corneal ulcers with hypopyon, hyphema, corneal fistula and phthisis bulbi have been reported in several studies using this model (3). Ma et al. (3) modified the Ormerod et al. (2) method, but still observed high levels of excessive corneal burn rates. Therefore, for these studies, we sought to modify the corneal alkali injury model in an effort to decrease excessive corneal burn rates and other complications associated with other models , specifically comparing the results from our modified corneal alkali rat model with the model employed by Ma et al. (3).

Effects of cultured human adipose-derived stem cells transplantation on rabbit cornea regeneration after alkaline chemical burn

Ocular chemical burn is a severe injury with poor outcomes. Immediate and appropriate management is highly related to prognosis. We studied the effect of cultured human adipose tissue-derived stem cells on the regeneration of the rabbit cornea after alkaline chemical burn, using used human adipose tissue-derived stem cells as the source material. Immediately after the chemical burn, the experimental eye received a single subconjunctival injection of a stem cell suspension (1.3 × 105 cells/0.2 mL), with the other eye serving as control. Rabbits were sacrificed and specimens taken 30 days after injection. The experimental group showed faster wound healing than the control group, and the result for the experimental group was clearer cornea medium. Histologically, there were five to six epithelial cell layers on the corneas of the experimental group as compared to two to three cell layers on the corneas of the control group. Wilcoxon signed rank test showed a significant difference in the epithelial cell layers between the two groups. Surface markers for connexin 43 (Cx43), β-catenin, E-cadherin, and P63 were analyzed. Cx43 and β-catenin showed significant change, as determined by the Wilcoxon signed rank test, which indicated good cell renewal during repair of the corneal epithelium damaged by the chemical burn. E-cadherin and P63 showed no significant change during the epithelium healing process. Transplantation of cultured human adipose tissue-derived stem cells as a treatment for a corneal chemical burn promotes cell renewal and assists in damage repair.

Cultivating oral mucosa epithelial transplantation (COMET) followed by penetrating keratoplasty (PK) in ocular surface reconstruction

AbstractPurpose Efficacy of COMET and subsequent PK in patients with limbal insufficiency combined with stromal corneal haze after corneal burnsMethods 15 patients (16 eyes)who underwent corneal burns with vascular conjuctival pannus and stromal involvement underwent autologous cultivated oral mucosa epithelial transplantation. Cellular material was obtained from buccal mucosa, tripsinized, and settled on the previously prepared culture dishes. Cultures was carried on denuded amniotic membrane in presence of inactivated with mitomycin C 3T3 fibroblasts. At least 12 month after epithelium restoration patients underwent PK. Corneal surface stability and visual acuity were evaluated.Results 6 month after last step of the surgery 68,7% of eyes had transparent cornea without reccurent revascularization, 31,2 % of eyes developed vascular pannus again with vascular ingrowth on the transplanted cornea ( in 2 cases visual axis was involved), in 62,5 % of eyes visual acuity increased from mean 0,01 to 0,3.Conclusion COMET combined with PK effectively improves ocular surface stability and quality of vision.