ABSTRACT
Autologous serum has been used to treat dry eye syndrome for many years. It contains several growth factors, vitamins, fibronectin and other components that have been considered important for corneal and conjunctival integrity. Serum eye drops are usually prepared as an unpreserved blood solution. The serum is by nature well tolerated and its biochemical properties are somewhat similar to natural tears. Autologous serum eye drops have been reported to be effective for the treatment of severe dry eye-related ocular surface disorders (Sjõgren's syndrome), and also other entities such as superior limbic keratoconjunctivitis, graft-versus-host disease, Stevens-Johnson syndrome, ocular cicatricial pemphigoid, recurrent or persistent corneal erosions, neurotrophic keratopathy, Mooren's ulcer, aniridic keratopathy, filtering blebs after trabeculectomy, and post-keratorefractive surgery. The purpose of this study is to review the recently published literature on ocular surface diseases treated with human autologous serum eye drops.
O soro autólogo tem sido adotado como uma nova abordagem para tratar síndrome do olho seco porque contém vitaminas, alguns fatores de crecimento e fibronectina que são considerados importantes contribuintes para integridade corneana e conjuntival. Colírio de soro autólogo é produzido sem preservativo. O soro é não-alérgico e suas propriedades bioquímicas são similares à lágrima. O soro autólogo tópico tem sido relatado efetivo para o tratamento de olho seco grave relacionado a distúrbios da superfície ocular como na síndrome de Sjõgren, ceratoconjuntivite límbica superior, doença do enxerto versus hospedeiro, síndrome de Stevens-Johnson, procedimentos cerato-refrativos, erosão corneana persistente ou recorrente, ceratopatia neurotrófica, úlcera de Mooren, ceratopatia associada à aniridia, e bolhas filtrantes após trabeculectomia. O objetivo do presente estudo é revisar a literatura recentemente publicada sobre doenças da superficie ocular tratadas com soro autológo tópico.
Subject(s)
Humans , Blood Transfusion, Autologous , Conjunctival Diseases/drug therapy , Corneal Diseases/drug therapy , Ophthalmic Solutions/therapeutic use , Serum , Dry Eye Syndromes/drug therapy , Intercellular Signaling Peptides and Proteins/therapeutic use , Serum/chemistryABSTRACT
O líquido amniótico banha o feto durante a vida intra-uterina e está em contato permanente com a superfície ocular durante este importante período do desenvolvimento. Ele contém uma série de fatores de crescimento que podem ter diversos efeitos sobre o processo cicatricial. Estes fatores aceleram a recuperação da sensibilidade corneana e regeneração nervosa após procedimentos cerato-refrativos, além de controlar a formação de cicatriz e o equilíbrio da superfície ocular após sua aplicação tópica. Centenas de diferentes proteínas têm sido identificadas no líquido amniótico humano e o papel de cada uma continua desconhecido. Os resultados obtidos até o momento sobre a aplicação de líquido amniótico em doenças de superfície ocular sugerem uma terapia promissora. Pesquisas estão sendo realizadas para identificar os efeitos dos fatores específicos do líquido amniótico sobre a inflamação ocular. O objetivo desta revisão é relatar as propriedades e utilizações atuais do líquido amniótico, bem como apresentar os recentes estudos relacionados ao uso deste líquido e doenças da superfície ocular.
Amniotic fluid bathes the fetus during intrauterine life and is in permanent contact with the fetal ocular surface in this important period of development. It contains a series of growth factors that may have multiple effects on the wound healing process. These factors are thought to accelerate the recovery of corneal sensitivity and nerve regeneration after keratorefractive procedures, and also may control scar formation and balance the ocular surface after topical application. Hundreds of different proteins have been identified in the human amniotic fluid, and the role of each still not quite understood. The outcomes obtained so far with amniotic fluid application to ocular surface diseases suggest a promising therapy. Research is underway to identify the effects of specific factors of the amniotic fluid in ocular inflammation. The purpose of this review is to report the properties and current utilizations of amniotic fluid as well as to summarize the recent studies related to the use of this fluid for ocular surface diseases.
Subject(s)
Humans , Amniotic Fluid , Conjunctival Diseases/therapy , Corneal Diseases/therapy , Administration, Topical , Amniotic Fluid/chemistry , Ophthalmic Solutions , Wound HealingABSTRACT
Autologous serum has been used to treat dry eye syndrome for many years. It contains several growth factors, vitamins, fibronectin and other components that have been considered important for corneal and conjunctival integrity. Serum eye drops are usually prepared as an unpreserved blood solution. The serum is by nature well tolerated and its biochemical properties are somewhat similar to natural tears. Autologous serum eye drops have been reported to be effective for the treatment of severe dry eye-related ocular surface disorders (Sjögren's syndrome), and also other entities such as superior limbic keratoconjunctivitis, graft-versus-host disease, Stevens-Johnson syndrome, ocular cicatricial pemphigoid, recurrent or persistent corneal erosions, neurotrophic keratopathy, Mooren's ulcer, aniridic keratopathy, filtering blebs after trabeculectomy, and post-keratorefractive surgery. The purpose of this study is to review the recently published literature on ocular surface diseases treated with human autologous serum eye drops.
Subject(s)
Blood Transfusion, Autologous , Conjunctival Diseases/drug therapy , Corneal Diseases/drug therapy , Ophthalmic Solutions/therapeutic use , Serum , Dry Eye Syndromes/drug therapy , Humans , Intercellular Signaling Peptides and Proteins/therapeutic use , Serum/chemistryABSTRACT
Amniotic fluid bathes the fetus during intrauterine life and is in permanent contact with the fetal ocular surface in this important period of development. It contains a series of growth factors that may have multiple effects on the wound healing process. These factors are thought to accelerate the recovery of corneal sensitivity and nerve regeneration after keratorefractive procedures, and also may control scar formation and balance the ocular surface after topical application. Hundreds of different proteins have been identified in the human amniotic fluid, and the role of each still not quite understood. The outcomes obtained so far with amniotic fluid application to ocular surface diseases suggest a promising therapy. Research is underway to identify the effects of specific factors of the amniotic fluid in ocular inflammation. The purpose of this review is to report the properties and current utilizations of amniotic fluid as well as to summarize the recent studies related to the use of this fluid for ocular surface diseases.
Subject(s)
Amniotic Fluid , Conjunctival Diseases/therapy , Corneal Diseases/therapy , Administration, Topical , Amniotic Fluid/chemistry , Humans , Ophthalmic Solutions , Wound HealingABSTRACT
Evaluar efectos en la tasa proliferación epitelial corneal usando 3 procedimientos quirúrgicos diferentes. 35 conejas albinas de Nueva Zelanda fueron divididas en 4 grupos (A,B,C,D) según tratamiento quirúrgico. Se les provocó una quemadura corneal química (NaOH 1M) en el ojo izquierdo en 360°. A los 5 días se les realizó tratamiento quirúrgico que consisttió en: Grupo A: trasnplante de Membrana Amniótica humana preservada. Grupo B: injerto Autólogo Límbico combinado con membrana amniótica. Grupo C: trasplante de células epiteliales limbales cultivadas sobre membrana amniótica humana. Grupo D: Sin tratamiento quirúrgico (grupo control). Cada 72 horas se tomaron fotos digitales colocando fluoresceína sódica y procesadas con programa analizador de imágenes. Se realizó estudio histológico de las muestras con microscopia de luz. Se observó que en los grupos de tratamiento el defecto epitelial fue menor con respecto al grupo control (p<0.002). No se observaron diferencias significativas entre los diferentes tratamientos quirúrgicos. En el análisis cuantitativo de los PMN de córnea y limbo observamos que los grupos A, B y C presentan diferencias significativas con p<0.05 respecto al grupo control; sin cambios significativos en el análisis de linfocitos. Los procedimientos quirúrgicos fueron eficientes en la reducción del defecto epitelial. El transplante de células límbicas cultivadas en membrana amniótica demostró ser más favorable en cuanto a los resultados anatómicos obtenidos
Subject(s)
Animals , Eye Burns , Biological Dressings , Epithelial Cells , Ophthalmology , VenezuelaABSTRACT
Reportar un caso de hipertensión ocular inducida por esteriodes con presencia de fluido en la interfase luego de queratomileusis láser (LASIK), diagnósticado de manera errónea como queratitis difusa lamelar (DLK). Paciente de sexo femenino de 53 años de edad presentó visión borrosa posterior a cirugía LASIK bilateral. La presión intraocular (PIO) era normal en ambos ojos con tonometría de aplanación. Fue reoperada 2 veces, diagnosticada con DLK de inicio tardío y tratada sin éxito con el uso de lentes de contacto terapéuticos, esteroides tópicos, antibióticos y solución salina hipertónica al 5 por ciento. Se encontró fluido en la entrecara y se sospechó la presencia y hipertensión ocular. Los esteroides fueron descontinuados y mejoró la agudeza visual. La tonometría de aplanación reveló entonces 30mmHg en ambos ojos, la cual retornó a valores normales con el uso de maleto timolol al 0.50 por ciento. El tratamiento de la DLK mal diagnósticada puede llevar al empeoramiento de una hipertensión ocular inducida por esteroides. Una cuidadosa evaluación biomicroscópica y corroboración de los valores de PIO es mandatario en estos pacientes
Subject(s)
Male , Humans , Female , Keratitis , Ocular Hypertension , Keratomileusis, Laser In Situ , Ophthalmology , VenezuelaABSTRACT
PURPOSE: To report a corneal perforation during laser in situ keratomileusis (LASIK) after previous electrothermokeratoplasty. DESIGN: Interventional case report. METHODS: A 49-year-old man presented with primary hyperopia in the right eye and residual hyperopia after electrothermokeratoplasty in the left eye. His refraction was +4.00 in the right eye and +7.00 -3.00 x 135 degrees in the left eye, with a central pachymetry of 535 microm and 549 microm, respectively. Phacoemulsification with intraocular lens (IOL) insertion in the right eye and a two-step keratophacorefractive procedure with a piggyback IOL insertion and LASIK in the left eye were proposed. RESULTS: Postoperative refraction was -0.50 -0.50 x 150 degrees 20/20 in the right eye. Postphacoemulsification refraction was -4.75 -4.25 x 135 degrees in the left eye. Laser in situ keratomileusis was performed in the left eye, 4 months later, with uneventful astigmatic laser ablation. During the myopic ablation, a sudden outcome of aqueous humor in one of the temporal corneal scars was observed. CONCLUSIONS: Unpredictably thin areas after electrothermokeratoplasty may lead to unexpected corneal perforation during LASIK. The available pachymetry systems may be unreliable after electrothermal keratoplasty.
Subject(s)
Cornea/surgery , Corneal Injuries , Electrocoagulation/methods , Eye Injuries/etiology , Hyperopia/surgery , Keratomileusis, Laser In Situ/adverse effects , Aqueous Humor/metabolism , Cornea/pathology , Corneal Topography , Eye Injuries/pathology , Humans , Lens Implantation, Intraocular , Male , Middle Aged , Phacoemulsification , Refraction, Ocular , Rupture , Visual AcuityABSTRACT
Observar la fluorescencia durante la ablación pulsada con láser éxcimer en córneas cadavéricas de conejos. Se expusieron 4 córneas cadavéricas de conejo a la energía del láser éxcimer de ArF a 1= 193nm. La fluorescencia resultante se registró a 45º de la incidencia del rayo y fue canalizada por un espectrómetro conectado a un analizador óptico multicanal capaz de leer un detector de diodo. La ablación continuó hasta la perforación. Los espectros obtenidos fueron sometidos a análisis por componentes principales (ACP). Se registraron los espectros del epitelio al endotelio. Se observaron cambios de espectros a medida que la ablación progresó. se evidenció una disminución obvia del pico de longitud de onda más corta a 367 nm. El ACP reveló que el espectro era consistente con datos obtenidos en córneas de humanos. Los resultados obtenidos pueden contribuir al conocimiento de los procesos que ocurren durante la ablación clínica con el láser éxcimer