Clinical uses of collagen shields.

Collagen shields immersed in tobramycin solution for one minute were applied to one eye each of 60 patients who had had cataract extraction, penetrating keratoplasty, or epikeratophakia or who had nonsurgical epithelial healing problems. The shields were well tolerated; one patient had the shield removed and one patient lost the shield in the early postoperative period. The surgical patients showed more rapid healing of epithelial defects after surgery with the use of the collagen shield. Patients with acute nonsurgical epithelial problems, such as contact lens abrasions and recurrent erosion, responded to the use of the collagen shield with improved healing. Patients with chronic epithelial defects responded poorly, presumably because underlying abnormalities in Bowman's layer prevented epithelial growth in the area of the defect. No infections were noted in any of the patients. The collagen shields appear to promote enhanced healing in patients with postsurgical and acute epithelial defects and to provide adequate antibiotic prophylaxis against infection in these vulnerable eyes.