Evaluation of the effect of umbilical cord blood serum therapy in resistant infected corneal ulcer

Abstract

Background Corneal wound healing involves several complex pathways that can be targeted by drugs with varying mechanisms of action. Infected corneal ulcers represent a special challenging situation facing ophthalmologists due to resistance to treatment and visual impairing complications. Purpose The aim of this study was to evaluate the efficacy of umbilical cord blood serum (CBS) as an adjunctive therapy for resistant infected corneal ulcers. Patients and methods This prospective cohort study included 40 eyes having infected corneal ulcer resistant to specific medical treatment for 2 weeks. The patients were recruited from the Cornea Unit at Tanta University Hospital, Tanta, Egypt. They were divided into two groups, 20 cases each. Group A cases were treated with umbilical CBS as an adjunctive therapy together with medical treatment based on culture and sensitivity testing, while group B cases continued the conventional medical treatment only till the complete healing was achieved. The results of the two groups were compared regarding the duration of healing and best-corrected visual acuity improvement. Results Visual acuity improvement was achieved with one or more line gain in 14 (70%) cases in group A compared to 6 (30%) cases in group B, with a statistically significant difference (P = 0.008). Healing was achieved in 16 (80%) cases of group A in 2–4 weeks compared to 14 (70%) cases of group B that achieved healing in a longer duration of 3–6 weeks, with a statistically significant difference (P = 0.001). Amniotic membrane transplantation AMT was required in 4 (20%) cases in group A due to thinning compared to 6 (30%) cases in group B. Conclusion Umbilical CBS was safe and effective when applied to the cornea as an adjunctive therapy in cases of resistant infected corneal ulcers where it accelerated healing with better visual outcome results.