Background: Corneal alkali burns are common ophthalmic emergencies which may lead to permanent visual impairment. In spite of great advances made in the treatment of these cases, the structural and functional restoration of corneal alkali burns remains challenging. Bone marrow-derived mesenchymal stem cells (BM-MSCs) have been demonstrated to enhance corneal healing. However the problem remains in finding a suitable vehicle to deliver BM-MSCs to the site of injury.
Objectives: To evaluate the therapeutic potential of BM-MSCs loaded on two biological vehicles (amniotic membrane versus platelet-rich plasma gel) in corneal alkali burns.
Materials & Methods: Fifty rats were randomly divided into five equal groups. Group I (control group), group II (corneal ulcer group) and group III (recovery group). Group IV rats with corneal ulcers were treated with amniotic membrane loaded with BM-MSCs while in the group V the rats with corneal ulcers were treated with platelet-rich plasma cells loaded with BM-MSCs. The corneal specimens were processed for the light microscope, transmission electron microscope examination, and RT qPCR assay for VEGF and iNOS.
Results: Group II showed epithelial separation and denudation with disorganized stroma and disrupted Descemet’s membrane and endothelium. Group III showed residual epithelial separation and vacuolation with neovascularization of the disorganized stroma. Group IV showed thinning of corneal epithelium with inflammatory infiltration of the stroma. Group V corneas revealed restoration of corneal epithelial thickness, organized stroma and continuous Descemet’s membrane. Also, there was an upregulation of iNOS & VEGF gene expression in groups II and III which was downregulated in group IV and V.
Conclusions: The combination of BM-MSCs with PRP gel was a promising treatment for corneal alkali burns and may be applicable for other types of corneal disorders.