Corneal Scar Treatment;
The cornea is the foremost transparent structure of the eye, where the light from the images passes into the deeper structure until it reaches the retina and is processed by the brain. It is important that the cornea remains transparent because any scar or opacity will prevent light from entering the eye. If a person has a vision-threatening injury on the cornea, it can usually be treated by removing damaged tissue and replacing it with a new cornea (corneal transplant).
Limbal Stem Cell Transplant
Normally, epithelial cells in the top layer of the cornea can be renewed if injured, but there are some diseases or injuries (such as chemical burns) for the epithelium that kill the limbal stem cells where the cornea and the white of the eye meet. These stem cells are normally located in the limbus, the region where the cornea (open, anterior part of the eye) meets the sclera (the white part of the eye). If a person has limbal stem cell deficiency, most treatments will fail and vision will drop significantly. For the last decades, researchers at the Regenerative Medical Center in many universities have treated patients who lost their vision due to chemical burns with techniques to replace damaged limbal stem cells.
Limbal stem cells are collected from the eye and then placed on the damaged eye. Transplanted stem cells begin to replenish the limbus of the damaged eye and produce normal epithelial cells that enlarge and cover the damaged cornea. The new growing healthy epithelium provides the protection and nutrition that the underlying cornea needs. The patient can then continue the corneal transplant or laser procedure to remove and replace deeper, damaged, injured corneal tissue, if necessary.
Amniotic membrane (AM) for corneal scar treatment is a form of treatment that can be used both separately and in combination with stem cell therapy. AM is a membrane harvested from the placental tissue obtained during elective caesarean section in a sterile environment. Those from whom the membrane is received are scanned for infectious diseases and are treated with broad-spectrum antibiotics immediately after AM collection.
Amniotic membrane application
Various features contribute to the effectiveness of AM in the treatment of ocular surface problems. Firstly, as AM heals, it acts as a physical barrier to protect the conjunctival and corneal epithelium, reducing pain caused by friction of the eyelids on the surface. In addition, the AM membrane supports epithelial growth through cell migration, adhesion and differentiation, while inhibiting cell migration as well as cell death. Also, the stroma of AM containing fetal hyaluronic acid inhibits fibroblast growth and reduces inflammation.
The use of this tissue in the office, in addition to other forms of treatment, can facilitate rapid wound healing, can resolve corneal staining faster and reduce scar formation, thereby improving the final visual outcome in complications such as corneal melt injury or secondary infection.
PTK - Laser application
PTK stands for phototherapeutic keratectomy and is a laser procedure used to reduce or eliminate corneal scar. Corneal scar can occur after trauma, infection, and even eye surgery. Often, corneal scarring causes blurred vision, poor visual quality, and problems with glare. Although PTK is an advanced technology that benefits many people, it has its limitations. It is not intended as a refractive procedure; that is, even after surgery, our patients may need an updated eyeglass or contact lens prescription. PTK is useful only in the treatment of superficial or only moderate corneal scar. It cannot completely cure excessively dense or deep scars.
PTK is not applied for deep or excessive corneal scars, active eye infections and very thin corneas.
