Allogeneic serum eye drops for the treatment of persistent corneal epithelial defect

The purpose of this study was to investigate the efficacy and safety of topical 100% serum eye drops for corneal epithelial defect after ocular surgery. A total of 181 patients who received topical 100% serum therapy for the treatment of corneal epithelial defect following several different types of ocular surgery were recruited into this study. Each patient already failed conventional medical therapy before being prescribed 100% serum eye drops. Slit-lamp biomicroscopic examination with fluorescein staining was performed at baseline and all follow-up visits. The main outcome measures were the rate of complete healing of the corneal epithelial defect and incidence of adverse events. One hundred and seventy-eight eyes (98.34%) received autologous serum eye drops, and 3 (1.66%) received allogeneic serum eye drops. The overall success rate of treating persistent postoperative epithelial defect using 100% serum eye drops was 93.92% (95% CI 0.88–0.98). The median time to complete corneal epithelialization was 4 days (95% CI 4-5). Adverse reactions were observed in 3 patients (1.66%), including sticky sensation with minimal eye discomfort and asymptomatic trace corneal subepithelial infiltration. No serious complications were reported. In conclusion, 100% serum eye drops are effective, safe, and tolerable for treating postoperative corneal epithelial defect following ocular surgeries.

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Autologous Serum Eye Drops for Post-Chemical Injuries and Corneal Epithelial Defects

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2013.009 ◽

2013 ◽

Vol 1 (1) ◽

pp. 45-49

Author(s):

Mirjana A. Janicijevic-Petrovic ◽

Marko Petrovic ◽

Dragan Vujic ◽

Katarina Janicijevic ◽

Andrijana Popovic

Keyword(s):

Success Rate ◽

Conventional Treatment ◽

Complete Healing ◽

Autologous Serum ◽

Eye Drops ◽

Epithelial Defect ◽

Corneal Epithelial ◽

Chemical Injuries ◽

Serum Therapy ◽

Serum Eye Drops

Aim: To evaluate success rate (efficacy, safety) in treatment of post-chemical injuries and corneal defects using autologous serum eye drops.Material and Methods: Authors reviewed 93 patients (116 eyes) hospitalized in Clinic of ophthalmology from 2010 to 2013, who had post-causoma corneal defects that were nonresponsive to conventional treatment and were treated with serum therapy. Authors correlated time of epithelialization of defects with rate of epithelial healing.Results: Authors investigated 93 patients (52 males, 41 females; aged 18 - 74) for treatment of corneal defects. Application of autologous serum therapy 56 (48.28%) of 116 eyes was healed in an average time of 4 weeks. Among 116 eyes, epithelial defects healed in 4 (3.45%) within 1 week, in additional 17 (14.65%) in 1-2 weeks, totalling 31 (26.72%) within 3 weeks. Five eyes (4.31%) completely healed at 5 week; three eyes (2.59%) had subsequent healing of epithelial defect at 6 week; 56 eyes completely healed within one month, and the remaining eight eyes healed within 1.5 month.Conclusion: Using serum therapy, it was managed to reduce time of healing from eleven weeks, which were necessary just couple years ago (before 2010) to four (maximum six) weeks to complete healing which are necessary today.

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A Case of Neurotrophic Keratopathy Associated with Nasopharyngeal Carcinoma

Case Reports in Ophthalmology ◽

10.1159/000485965 ◽

2018 ◽

Vol 9 (1) ◽

pp. 114-118 ◽

Cited By ~ 1

Author(s):

Tomoko Sato ◽

Koji Sugioka ◽

Aya Kodama-Takahashi ◽

Masahiko Fukuda ◽

Hiroshi Mishima ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Cavernous Sinus ◽

Visual Disturbance ◽

Amniotic Membrane Transplantation ◽

Eye Drops ◽

Epithelial Defect ◽

Corneal Epithelial ◽

Corneal Epithelial Defect ◽

Defect Area ◽

Neurotrophic Keratopathy

Purpose: To report a case of neurotrophic keratopathy associated with nasopharyngeal carcinoma. Case Report: A 59-year-old man who had been diagnosed with a nasopharyngeal carcinoma was referred to the authors because of visual disturbance and pain in his right eye. Slit-lamp examination revealed a corneal epithelial defect and corneal stromal edema surrounding the epithelial defect area in his right eye. Magnetic resonance imaging showed a mass in his cavernous sinus, which was identified as nasopharyngeal carcinoma (NPC). We diagnosed neurotrophic keratopathy associated with NPC and initiated treatment with preservative-free artificial tears, antibiotic eye drops, fibronectin, a therapeutic contact lens, and amniotic membrane transplantation. However, the persistent corneal epithelial defect was unresponsive to these treatments. Conclusion: Neurotrophic keratopathy secondary to NPC is thought to be rare. We presented a case of neurotrophic keratopathy associated with cavernous sinus metastasis of an NPC. The development of new and more effective treatments for this refractory disease is anticipated.

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Human Serum Eye Drops in Eye Alterations: An Insight and a Critical Analysis

Journal of Ophthalmology ◽

10.1155/2015/396410 ◽

2015 ◽

Vol 2015 ◽

pp. 1-14 ◽

Cited By ~ 4

Author(s):

Maria Rosaria De Pascale ◽

Michele Lanza ◽

Linda Sommese ◽

Claudio Napoli

Keyword(s):

Human Serum ◽

Clinical Studies ◽

Tear Film ◽

Eye Drops ◽

Corneal Epithelial ◽

Activated Platelets ◽

Open Debate ◽

Potential Benefits ◽

Serum Eye Drops

Human serum contains a physiological plethora of bioactive elements naturally released by activated platelets which might have a significant effect on the regeneration of corneal layers by stimulating the cell growth. This mechanism supported the use of human serum eye drops in some ocular diseases associated with dystrophic changes and alterations of the tear film, such as persistent corneal epithelial defects and dry eye syndrome. We focused our effort on potential benefits and limitations of the use of human serum eye drops when conventional therapies failed. We reviewed the recent literature by reporting published studies from 2010 to 2014. Despite the limited evaluated study populations, most of the clinical studies have confirmed that serum eye drop therapy is effective in corneal healing by reducing ocular symptom, particularly during the short-term follow-up. In addition, three recent published studies have shown the efficacy of the serum eye drop therapy in comparison to traditional ones in intractable patients. Besides, reported ongoing clinical studies confirmed the open debate regarding the use of biologic tools for cornea regeneration. Results from these studies might open novel challenges and perspectives in the therapy of such refractory patients.

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Corneal Epithelial Defect May Affect Anterior Chamber Flare

Journal of Refractive Surgery ◽

10.3928/1081-597x-19961101-04 ◽

1996 ◽

Vol 12 (7) ◽

pp. 755-755

Author(s):

Ran Sun ◽

Howard V Gimbel

Keyword(s):

Anterior Chamber ◽

Epithelial Defect ◽

Corneal Epithelial ◽

Corneal Epithelial Defect ◽

Anterior Chamber Flare

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Amnwiotic Membrane Transplantation as a Treatment for Sterile Infiltration and Corneal Melting after Corneal Crosslinking for Keratoconus

Case Reports in Ophthalmology ◽

10.1159/000487074 ◽

2018 ◽

Vol 9 (1) ◽

pp. 185-189 ◽

Cited By ~ 1

Author(s):

Takanori Sasaki ◽

Takeshi Ide ◽

Ikuko Toda ◽

Naoko Kato

Keyword(s):

Visual Acuity ◽

Diclofenac Sodium ◽

Corneal Stroma ◽

Amniotic Membrane Transplantation ◽

Eye Drops ◽

Epithelial Defect ◽

Persistent Epithelial Defect ◽

Corneal Crosslinking ◽

Corneal Epithelial Defect ◽

Corneal Melting

We report a case of corneal melting through sterile infiltration presumably due to excessive use of nonsteroidal anti-inflammatory eye drops after corneal crosslinking (CXL). It was treated using steroids combined with amniotic membrane transplantation (AMT). A 33-year-old man with progressing keratoconus underwent left eye CXL. We prescribed betamethasone and levofloxacin eye drops 5 times daily and diclofenac sodium eye drops 3 times daily for 3 days. Three days after CXL, there was a persistent epithelial defect and the left corneal stroma was clouded. His visual acuity remained unchanged. We prescribed betamethasone hourly and 20 mg prednisolone daily. At 1 week after CXL, the corneal epithelial defect and infiltration were unchanged. He had not stopped using diclofenac at the prescribed time. On day 17, we performed AMT and his cornea and visual acuity improved. AMT may be effective against persistent epithelial defects and corneal melting after CXL.

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Severe Corneal Complications Associated With Corneal Lubricant Used During Surgery

Journal of VitreoRetinal Diseases ◽

10.1177/2474126417698880 ◽

2017 ◽

Vol 1 (3) ◽

pp. 187-190

Author(s):

Andrew C. Lee ◽

E. Mitchel Opremcak ◽

Christiane Hunt ◽

Juan A. Astruc ◽

Brian Toussaint ◽

...

Keyword(s):

Treatment Method ◽

The United States ◽

Posterior Segment ◽

Epithelial Defect ◽

Chemical Burns ◽

Corneal Epithelial ◽

Corneal Injury ◽

Corneal Epithelial Defect ◽

Time Period ◽

Litmus Paper

Purpose: To present a series of cases of corneal chemical burns associated with the use of likely improperly buffered corneal lubricant gel, Goniovisc, during uncomplicated, posterior segment surgery. Methods: Cases of postoperative corneal complications following surgeries in which Goniovisc was used were collected from 6 retina practices across the United States between January and August 2016. The preoperative diagnosis, type of procedure, postoperative day 1 corneal findings, treatment method, and time to resolution of the corneal irregularity were recorded. pH testing of Goniovisc lots from this time period was performed using Hydrion litmus paper. Results: A total of 157 eyes of 156 patients were found to have corneal complications following relatively simple posterior segment surgeries in which Goniovisc was used. Findings included one or more of the following: corneal epithelial defect (84% of cases), Descemet folds (34%), stromal edema (14%), and superficial punctate keratitis (3%). Time to resolution ranged from 2 to 90 days (mean, 12 days; median, 7 days). Treatment methods included artificial tears (37%), bandage contact lens (28%), antibiotic drops (17%), antibiotic ointment (16%), and patching (9%). Two cases were treated with amniotic membrane grafts. One case required a penetrating keratoplasty due to an old laser-assisted in situ keratomileusis (LASIK) flap with a nonhealing epithelial defect that scarred significantly. Litmus testing of Goniovisc lots from this time period revealed a pH of 4 to 5. Conclusion: Chemical burns secondary to improperly buffered corneal lubricant solution should be considered in the differential when corneal injury is encountered following posterior segment surgery.

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