Combined Umbilical Cord Stem Cell With Amniotic Membrane Graft Transplantation For Chemical Burn Patient
Published 2023 - 41st Congress of the ESCRS
Reference: PO0159 | Type: Case report | DOI: 10.82333/bgky-5y31
Authors: Karim El Mowafi* 1 , Rania Kamel 2
1ophthalmology ,Mansoura health insurance hospital ,mansoura,Egypt, 2ophthalmology ,mansoura ophthalmic center,mansoura,Egypt
The aim of this study is Evaluation role of combined limbal stem cell with amniotic membrane graft transplantation for chemical burn and thinning by assessment of healing of corneal epithelium, increased corneal thickness in case with corneal thinning by using slit lamp bio microscopy and anterior segment optical coherence tomography. Moreover, BCVA before and after procedure monitoring
The patient underwent a biopsy of the limbus from the fellow eye; the biopsy material was cultivated on fibrin, a natural substrate that preserves holoclone-forming cells. The fibrin-cultured epithelial sheet has been grafted over the corneal and limbal region of the injured eye, where the receiving bed had been previously surgically prepared. The A.Mwas then sutured over the peripheral fibrin sheet and the whole cornea with suture .
A 50-year-old man with a 21-year history of chemical burn of the cornea caused by phosphoric acid in his left eye presented to our hospital with unilateral total LSCD, severe corneal conjunctivalization, cataract, and a corrected distance visual acuity (CDVA) limited to hand motion in the affected eye. After, combined limbal stem cell with amniotic membrane transplantation for the patient’s eye. The preoperative CDVA was limited to hand motion. Three days before the autologous LSC combined with amniotic membrane transplantation. The corneal surface became regular and transparent. Renewal of the corneal epithelium appeared within the first week after transplantation. Two weeks after surgery, the patient’s best corrected visual acuity was 20/50. After 30 days from transplantation, we observed almost complete corneal epithelium renewal, a regression of peripheral edema.
Several surgical procedures have been proposed for the treatment of chemical burn patients with LSCD in order to restore the limbal stem cell reservoir. After more than 50 years of trials, no consensus on guidelines for the management of this challenging condition has been reached. In fact, while improvement of quality of life, visual acuity, or ocular surface may be considered a clinical success, to define a success of LSCT is necessary to combined it with amniotic membrane transplantation specifically in patients presented by Chemical burn with large corneal epithelial defect. Recently, umbilical cord patching is a promising alternative procedure which could be used in management of corneal surface reconstruction in acute chemical burn .