Topical insulin for refractory persistent corneal epithelial defects

2020 ◽  
pp. 112067212095830
Author(s):  
David Diaz-Valle ◽  
Barbara Burgos-Blasco ◽  
Jose A Gegundez-Fernandez ◽  
Sara Garcia-Caride ◽  
Virginia Puebla-Garcia ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Healing Time ◽  
Bullous Keratopathy ◽  
Eye Drops ◽  
Ocular Surgery ◽  
Corneal Epithelial ◽  
Area Reduction ◽  
Mean Time ◽  
Persistent Epithelial Defects

Purpose: To evaluate insulin eye drops for persistent epithelial defects (PEDs) that are refractory to usual treatment in clinical practice and to analyze how it may improve epithelization. Methods: A prospective non-randomized hospital-based study was performed. Patients with PEDs that were refractory to conventional treatment were treated with insulin eye drops four times a day. Patients’ demographics, PED etiology, concomitant treatments, and comorbidities were reviewed. The rate of PED closure and epithelial healing time were considered the primary outcome measures. Results: 21 patients were treated with insulin drops (12 females and 9 males; mean age 72.2 years). Mean PED area before treatment was 17.6 ± 16.5 mm2 (median 13.2; range 3.9–70.6). PED comorbidities included seven eyes with infectious keratitis (33%), five eyes with calcium keratopathy (24%), ocular surgery on three eyes (14%), three eyes with lagophthalmos (14%), two eyes with bullous keratopathy (10%), and one patient with herpetic eye disease (5%). The eyes of 17 patients (81%) with refractory PEDs had reepithelized and four patients (19%) had still presented an epithelial defect by the end of the study follow-up period, although it had decreased in size. In patients where PED closure was achieved, mean time until reepithelization was 34.8 ± 29.9 days (median 23; range 7–114). In the remaining patients, a mean area reduction of 91.5% was achieved for the PEDs. Conclusion: Topical insulin can promote and accelerate corneal reepithelization of refractory PEDs. It also offers many other advantages, including excellent tolerance, availability, and cost-effectiveness.

scholarly journals Topical 100% Serum Eye Drops for Treating Corneal Epithelial Defect after Ocular Surgery

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Kaevalin Lekhanont ◽  
Passara Jongkhajornpong ◽  
Lulin Choubtum ◽  
Varintorn Chuckpaiwong
Keyword(s):  
Complete Healing ◽  
Autologous Serum ◽  
Eye Drops ◽  
Epithelial Defect ◽  
Ocular Surgery ◽  
Corneal Epithelial ◽  
Corneal Epithelial Defect ◽  
Conventional Medical Therapy ◽  
Serum Eye Drops

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.

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

2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
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.

scholarly journals Autologous Blood Products: When, Where, and How?

2021 ◽  
Vol 8 (1) ◽  
pp. 1-9
Author(s):  
Alfonso L Sabater ◽  
Keyword(s):  
Ocular Surface ◽  
Keratoconjunctivitis Sicca ◽  
Therapeutic Option ◽  
Autologous Blood ◽  
Stevens Johnson Syndrome ◽  
Eye Drops ◽  
Corneal Epithelial ◽  
Johnson Syndrome ◽  
Ocular Surface Diseases ◽  
Persistent Epithelial Defects

Autologous blood eye drops have become an interesting, well-known, and widely used therapeutic option for many ocular surface diseases since their introduction into the ophthalmologic field forty-six years ago. The foundation for their use in the treatment of pathologies such as severe keratoconjunctivitis sicca, persistent epithelial defects, ocular chemical burns, recurrent epithelial erosions, Stevens-Johnson syndrome, ocular graft versus host disease, and, lately, in many other ocular surface conditions, relies on the fact that they contain proteins, vitamins, cytokines, and growth factors that participate in the signaling pathways of corneal epithelial healing in similar amounts to those found in normal, healthy tear films

Treatment of persistent epithelial defects with single-dose autologous serum eye drops

2021 ◽  
pp. 112067212110483
Author(s):  
Selma Özbek-Uzman ◽  
Züleyha Yalnız-Akkaya ◽  
Evin Şingar Özdemir ◽  
Ayşe Burcu
Keyword(s):  
Single Dose ◽  
Healing Time ◽  
Autologous Serum ◽  
Eye Drops ◽  
Artificial Tears ◽  
Duration Of Treatment ◽  
The Mean ◽  
Preservative Free ◽  
Serum Eye Drops

Purpose: We aimed to investigate the efficacy and safety of single-dose autologous serum eye drops (ASEDs) for treatment of persistent corneal epithelial defects (PEDs). Methods: About 34 eyes of 26 patients treated from March 2016 to May 2020 with a single dose of ASEDs for PEDs that did not respond to conventional treatment were retrospectively evaluated. Patient demographics, predisposing factors, size, and duration of the PED, duration of treatment, and dosage of ASEDs, PED healing time, success rate of the ASED treatment, and follow-up time after the onset of ASED treatment were recorded. Autologous serum eye drops (20%) were prepared by diluting the serum with preservative-free artificial tears in single-dose vials. Vials were stored at −20°C and used daily after dissolving. Results: The mean patient age was 47.0 ± 18.5 years, and 13 (50%) of the patients were male. The most common indication for ASEDs was PED after keratoplasty. The mean duration of ASED treatment was 8.5 ± 6.3 months, and mean follow-up time was 22.8 ± 12.2 months. Autologous serum eye drop treatment was effective in 25 (73.5%) eyes and partially effective in 5 (14.7%) eyes. None of the eyes displayed complications related to the treatment. Conclusion: In patients with PED for whom conservative treatment is insufficient, ASEDs prepared by dilution with preservative-free artificial tears in single-dose vials and administered based on the daily use principle appear to be effective and safe.

scholarly journals Outcomes of Resident-Performed Descemet's Stripping Automated Endothelial Keratoplasty

2017 ◽  
Vol 09 (01) ◽  
pp. e26-e31
Author(s):  
Tatyana Beketova ◽  
Margaret Pfeiffer ◽  
Alice Chuang ◽  
Gene Kim
Keyword(s):  
Graft Failure ◽  
Glaucoma Patient ◽  
Case Series ◽  
Glaucoma Surgery ◽  
Bullous Keratopathy ◽  
Endothelial Keratoplasty ◽  
Ocular Surgery ◽  
Pseudophakic Bullous Keratopathy ◽  
Primary Graft Failure

Purpose This article aimed to evaluate outcomes of resident-performed Descemet's stripping automated endothelial keratoplasty (DSAEK). Methods This is a case series of patients who underwent DSAEK performed by PGY-4 ophthalmology residents at Lyndon B. Johnson Hospital from January 2013 to August 2016 staffed by a fellowship-trained cornea specialist. Patients with less than 1 month of follow-up were excluded. Demographics, baseline ocular characteristics, and intraoperative data were recorded. Vision and graft status were recorded at 1 week, 1 month, 3 months, and the last follow-up visits. Surgical failure was defined as graft detachment within 1 week of surgery and/or primary graft failure within 3 months of surgery. Results Eighteen eyes of 18 patients who followed up for 14.9 months (±12.9) were included. Mean age of patients was 60.9 years (±13.2). Indications for DSAEK included pseudophakic bullous keratopathy (10), Fuchs endothelial dystrophy (4), and other causes of endothelial dysfunction (4). Eleven (61%) eyes had prior ocular surgery, and 7 (39%) had prior glaucoma surgery. There were no postoperative graft detachments and two (11%) primary graft failures. There was one primary graft failure in a glaucoma patient. Of the 16 graft successes, logMAR visual acuity improved by 0.46 logMAR (±0.73) from baseline. Conclusion With appropriate staffing by an experienced cornea surgeon, DSAEK with residents as the primary surgeons is a safe and effective procedure with reasonably good outcomes.

scholarly journals Treatment of Noninfectious Corneal Disorders With Plasma Rich in Growth Factors and ReGenerating Agent Matrix

2020 ◽  
Author(s):  
Ronald Mauricio Sanchez-Avila ◽  
Edmar Uribe-Badillo ◽  
Carlos Fernandez-Vega Gonzalez ◽  
Francisco Muruzabal ◽  
Borja De la Sen Corcuera ◽  
...  
Keyword(s):  
Growth Factors ◽  
Adverse Events ◽  
Corneal Ulcer ◽  
Eye Drops ◽  
Ocular Surface Disease Index ◽  
Corneal Ulcers ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
Mean Time

Abstract Background: To provide the efficacy and safety of Plasma Rich in Growth Factors (PRGF) associated with tissue ReGeneraTing Agent (RGTA) drops for the treatment of noninfectious corneal ulcers.Methods: This retrospective study included patients from Fernandez-Vega University Institute between 2010 and 2019, with noninfectious corneal ulcers and no response to standard treatments. RGTA treatment was firstly applied (1 drop every two days), but if ulcer closure was not achieved, PRGF eye drops treatment was added (4 times/day). The time to reach the ulcer closure; the Best Corrected Visual Acuity (BCVA), intraocular pressure (IOP), Visual Analog Scale (VAS, in frequency and severity of symptoms), and Ocular Surface Disease Index (OSDI) were evaluated. The presence of adverse events along the follow-up period was also reported. Results: Seventy-four patients (79 eyes) were included in the study, forty-six eyes (62.2%) were women, and the mean age was 56.8 ± 17.3 years. The neurotrophic corneal ulcer was the most frequent disorder found in the patients of the study (n = 27, 34.2%), mainly due to the herpes virus (n = 15, 19.0%). The mean time of PRGF eye drops treatment associated with RGTA matrix was 4.2 ± 2.2 (1.5 -9.0) months, and the follow-up period was 44.9 ± 31.5 months. The ulcer closure was achieved in 76 eyes (96.2%). BCVA, VAS and OSDI improved significantly from the baseline (p<0.001), while IOP remained unchanged (p=0.665). No adverse events were recorded. Conclusions: The use of RGTA and PRGF in noninfectious ulcers was effective and safe, and it could be a therapeutic alternative for this type of corneal diseases.

scholarly journals Role of topical cyclosporine in prevention of pterygium recurrence, after primary excision.

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Munawar Ahmed
Keyword(s):  
Healing Time ◽  
Complete Healing ◽  
P Value ◽  
Eye Drops ◽  
Fellow Eye ◽  
Department Of Ophthalmology ◽  
Prospective Comparative Study ◽  
Recurrent Pterygium

Role of topical cyclosporine in prevention of pterygium recurrence, after primary excision. Purpose: To evaluate the effect of cyclosporine on pterygium recurrence after primary excision Study Design: Non randomized prospective comparative study. Place and Duration of Study: The study was conducted in the department of Ophthalmology Liaquat University of Medical and Health Sciences Jamshoro from 2015 to 2017 Material and Methods: One hundred and thirty eyes of 65 patients having bilateral pterygium, at least 2mm encroaching on the cornea, were randomly selected for study. After informed consent patient was seen on slit lamp, the dimensions of pterygium was measured. The eye with more pterygium was selected for post-operative cyclosporine and was named as cyclo- eye and fellow eye was selected for simple excision and was named as non-cyclo eye. Immediate post-operative treatment was tobramycin dexamethasone eye ointment twice and moxifloxacine eye drops three times daily until corneal epithelium was restored, followed by moxifloxacine and Cyclosporine eye drops twice daily until complete healing of ocular surface occurred and then cyclosporine 0.05% alone once daily in the evening up to three months. In the fellow eye tobramycin dexamethasone eye ointment and moxifloxacine eye drops were used for complete healing time followed by tears alone three times for three months. Recurrence was defined as 1mm encroachment of pterygium on the cornea. Follow up was done for six months. Results: Fifty-three patients who completed 6 months follow were only included in the results. In cyclo-eyes recurrent pterygium was observed only in 04(07.55%) and in non-cyclo eyes recurrence was observed in 23(43.40%). Therefore, cyclosporine was able to reduce pterygium recurrence further in 19(35.85%) eyes, but healing time increased. Mean healing time in cyclo-eyes 21.1354 days and in non-cyclo-eyes 15.0213 days. Standard deviation in cyclo-eyes 1.3412 and in non-cyclo-eyes 1.0413. P-value was 0.002 and 0.004 respectively. Conclusion: Cyclosporine is effective in reducing the recurrence rate of pterygium. Key words: Pterygium, cyclosporine, recurrence  

The rate of successful four-corner arthrodesis with a locking, dorsal circular polyether-ether-ketone (PEEK-Optima) plate

2013 ◽  
Vol 38 (7) ◽  
pp. 767-773 ◽  
Author(s):  
P. C. Rhee ◽  
A. Y. Shin
Keyword(s):  
Circular Plate ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Accurate Assessment ◽  
Polyether Ether Ketone ◽  
The Mean ◽  
Ether Ketone ◽  
Mean Time

The purpose of this study is to evaluate the rate of union after four-corner arthrodesis with a locking, dorsal circular plate comprised of polyether-ether-ketone. A retrospective review was conducted of all patients who underwent four-corner arthrodesis with a locking, dorsal circular plate at our institution from January 2005 to May 2009. The primary outcome measure was radiographic and clinical union. During the study period, 26 consecutive wrists underwent four-corner arthrodesis with a locking, dorsal circular plate. Twenty-three wrists were included. The mean clinical follow-up was 16 months (range 3–37). Union was achieved in 22 of 23 wrists at a mean time of 3 months (range 1–12). There was one partial union that underwent successful revision arthrodesis. In summary, four-corner fusion with a polyether-ether-ketone locking, dorsal circular plate results in high union rates. The use of a radiolucent plate allows for more accurate assessment of union with the biomechanical advantages of a fixed angle construct.

scholarly journals Erratum to “Topical 100% Serum Eye Drops for Treating Corneal Epithelial Defect after Ocular Surgery”

2014 ◽  
Vol 2014 ◽  
pp. 1-1
Author(s):  
Kaevalin Lekhanont ◽  
Passara Jongkhajornpong ◽  
Lulin Choubtum ◽  
Varintorn Chuckpaiwong
Keyword(s):  
Eye Drops ◽  
Epithelial Defect ◽  
Ocular Surgery ◽  
Corneal Epithelial ◽  
Corneal Epithelial Defect ◽  
Serum Eye Drops

scholarly journals Role of Topical Cyclosporine in Prevention of Pterygium Recurrence, after Primary Excision

2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Munawar Ahmed, Atif Mansoor Noman Ahmed, Ghazi Khan Mari Azfer Ahmed Mirza
Keyword(s):  
Controlled Trial ◽  
Healing Time ◽  
Complete Healing ◽  
Eye Drops ◽  
Once Daily ◽  
Randomized Controlled ◽  
Department Of Ophthalmology ◽  
Recurrent Pterygium

Purpose: To study the effect of cyclosporine on pterygium recurrence after primary excision Study Design: Non randomized controlled trial. Place and Duration of Study: The study was conducted in the department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro from 2015 to 2017. Material and Methods: One hundred and thirty eyes of 65 patients having bilateral pterygium, at least 2 mm encroaching on the cornea, were selected for study. Dimensions of pterygium were measured on slit lamp. Half of the eyes were selected for post-operative cyclosporine and was named as cyclo- eye and fellow other eye was named as non-cyclo eye. Immediate post-operative treatment was tobramycin dexamethasone eye ointment twice and moxifloxacin eye drops three times daily until corneal epithelium was restored, followed by moxifloxacin and Cyclosporine eye drops twice daily until complete healing of ocular surface occurred and then cyclosporine 0.05% alone once daily in the evening up to three months. In the fellow eye tobramycin dexamethasone eye ointment and moxifloxacin eye drops were used for complete healing time followed by tears alone three times for three months. Follow up was done for six months. Results: Only Fifty-three patients who completed 6 months of follow-up were included in the results. In cyclo-eyes recurrent pterygium was observed only in 4 (07.55%) and in non-cyclo eyes recurrence was observed in 23 (43.40%) eyes. Mean healing time in cyclo-eyes was 21.1354 days and in non-cyclo-eyes, 15.0213 days. Conclusion: Cyclosporine is effective in reducing the recurrence rate of pterygium. Key Words: Pterygium, Cyclosporine, Cornea.

Sign in / Sign up

Export Citation Format

Share Document