Yu-Kuei Lee1, Yen-Chun Lin1, Shih-Hao Tsai1, Wei-Li Chen2, Yan-Ming Chen3. 1. Department of Ophthalmology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. 2. Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. 3. Department of Ophthalmology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: louice1070@yahoo.com.tw.
Abstract
PURPOSE: To evaluate the efficacy of the combination of topical 20% autologous serum eye drops (ASEs) and silicone-hydrogel soft contact lenses (SCLs) for the treatment of corneal persistent epithelial defects (PEDs), and to compare the recurrence of epithelial breakdown with or without continuous use of ASEs after silicone-hydrogel SCLs removal. METHODS: We conducted a prospective interventional study of 21 eyes of 21 patients with PEDs treated with combined ASEs and silicone-hydrogel SCLs from September 2014 to August 2015. SCLs were removed after total re-epithelialization and patients were subsequently randomized divided into two groups: (1) with and (2) without continuous use of ASEs for an additional 2 weeks. PEDs healing rate and epithelial defect recurrence were evaluated. RESULTS: PEDs healed in all eyes within 3 weeks. Recurrence was noted in five eyes (50%) in patients without continued use of ASEs for 2weeks after total re-epithelialization and SCLs removal during a 3-month follow-up (odds ratio: 23.0; P<0.05). Recurrent epithelial defects were successfully treated with secondary SCLs application combined with autologous serum use. No adverse events were noted during the entire treatment period. CONCLUSIONS: The combined use of ASEs and silicone-hydrogel SCLs can successfully treat recalcitrant PEDs. Prolonged use of ASEs after total re-epithelialization can decrease recurrence rates.
RCT Entities:
PURPOSE: To evaluate the efficacy of the combination of topical 20% autologous serum eye drops (ASEs) and silicone-hydrogel soft contact lenses (SCLs) for the treatment of corneal persistent epithelial defects (PEDs), and to compare the recurrence of epithelial breakdown with or without continuous use of ASEs after silicone-hydrogel SCLs removal. METHODS: We conducted a prospective interventional study of 21 eyes of 21 patients with PEDs treated with combined ASEs and silicone-hydrogel SCLs from September 2014 to August 2015. SCLs were removed after total re-epithelialization and patients were subsequently randomized divided into two groups: (1) with and (2) without continuous use of ASEs for an additional 2 weeks. PEDs healing rate and epithelial defect recurrence were evaluated. RESULTS: PEDs healed in all eyes within 3 weeks. Recurrence was noted in five eyes (50%) in patients without continued use of ASEs for 2weeks after total re-epithelialization and SCLs removal during a 3-month follow-up (odds ratio: 23.0; P<0.05). Recurrent epithelial defects were successfully treated with secondary SCLs application combined with autologous serum use. No adverse events were noted during the entire treatment period. CONCLUSIONS: The combined use of ASEs and silicone-hydrogel SCLs can successfully treat recalcitrant PEDs. Prolonged use of ASEs after total re-epithelialization can decrease recurrence rates.
Authors: Uma Vaidyanathan; Grant C Hopping; Harry Y Liu; Anisha N Somani; Yasmyne C Ronquillo; Phillip C Hoopes; Majid Moshirfar Journal: Med Hypothesis Discov Innov Ophthalmol Date: 2019