Clear Cornea Post Sever Chemical Burn Without Keratoplasty

To show that the marvelous effect of using  auto graft limbal stem cell and amniotic membrane and auto serum eye drops to reach clear cornea post sever chemical burn without the  need to do keratoplasty  but to reach this point we need long time

the memorial institute for ophthalmic research 

 patient came complaining of drop of vision in the RT eye post chemical injury 6 m. ago . Examination showed that complete conjunctivalization of  cornea due to destruction of all stem cells in this eye  , symblepharon , closed fornices , the vision was HM and u/s showed retina in place . I decided to do limbal stem cell transplantation from  other eye then wait  until have good limbal stem cells in this eye then do keratoplasty. In operation , I excised  adhesions and  fibrous tissue on the surface of the cornea , prepare the stem cells from other eye , suturing them at  sides of the cornea at zero and 180 degree then fashion a large layer of the fresh amniotic membrane that cover the cornea and large area of sclera and suture  amniotic to the sclera , then suture  residual parts of conjunctiva above the amniotic  (shown in video) . start treatment with prepared auto serum eye drops from the next day for at least 2 months .after 3 months the vascularization of the  cornea disappear and cornea became more clear and the vision improve to 6/60 and it is irrefractable . after 6 months , the cornea became more clear with the vision improved to 6/24 by -1.0 x -4.50 @140 and fundus examination showed retina in place with disc cupping 0.4 and ORA showed corrected iop 28 so I started to give 1 antiglaucoma eyedrop . after 1 year , the cornea became almost clear with BCVA 6/12 by plano/-2.5@140 and iop controlled by medical TTT , the pentacam showed the thinnest location was 360 um .

Chemical burn to the eye usually have a very poor prognosis

Limbal stem cell transplantation is the only hope for those patient who have massive destruction of their original stem cells

Use the amniotic membranes  and auto serum eyedrops  help the healing of these cases and some times give unexpected marvelous results that the corneas become almost clear and  we donot need to do keratoplasty but this need long time