Artikel
The benefits of matrix regenerative therapy in progressive corneal thinning due to bilateral corneal melting ulcer, Sjögren's syndrome and rheumatoid arthritis (P1)
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Veröffentlicht: | 9. Juni 2015 |
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Purpose: To presents results of novel therapy application in patient with progressive bilateral corneal thinning. To evaluate the usefulness of this therapy.
Methods: This report presents a patient with rheumatoid arthritis and Sjögren's syndrome with severe dry eye complicated with non-healing melting corneal ulcers, which occurred bilaterally. The patient also suffered from severe depression and therefore received psychotropic medication. In the right eye because of severe corneal thinning segmental keratoplasty was performed. This was before new matrix therapy introduction. In the left eye corneal thinning was not as advanced as in the right eye. New corneal matrix regenerating therapy (ReGeneraTing Agent [RGTA], Cacicol-20) was applied topically in both eyes. The eye drops were instilled once a week. Evolution during the treatment was assessed by best corrected visual acuity (BCVA), slit lamp examination, photography of cornea and anterior segment optical coherent tomography CASIA, Tomey (AS-OCT).
Results: In above mentioned entity persistent inflammatory process, wound healing defect, factors such as stress, infection or drug side effects have caused significant damage of cornea. Corneal stroma regenerant contributed to persistent corneal ulcers healing. It promoted epithelialization and supported further reconstruction of the corneal stroma. Patient displayed BCVA improvement in both eyes, decrease in edema of corneal transplant in the right eye, significant, gradual increase in corneal thickness in the left eye and improvement in the quality of life after novel therapy introduction.
No systemic or local side effects of the treatment were reported.
Conclusions: Despite the advancement of ophthalmology, progressive corneal thinning, which may be secondary to systemic or eye diseases, is difficult to treat and is often resistant to medications. RGTA stopped the progression of corneal thinning and enhanced matrix regeneration. The treatment prevented the patient from undergoing re-keratoplasty in the right eye and keratoplasty in the left eye. It has appeared to be potentially useful, alternative, noninvasive therapeutic approach in progressive corneal thinning.