Treatment of persistent corneal epithelial defect by autologous serum application☆
Section snippets
Patients with persistent epithelial defect
We defined PED as “a corneal epithelial defect persisting more than 2 weeks without improvement despite conventional treatment such as artificial tears or extended wear soft contact lenses.” A total of 16 eyes of 15 patients were diagnosed with PED and were recruited for this study (Table 1). The original diseases involved six patients with cicatricial keratoconjunctivitis sicca (three ocular pemphigoid and three Stevens-Johnson syndrome; two males and four females; mean age, 62.5 ± 16 years),
Stability of tear components in 20% diluted serum
The concentration of vitamin A, EGF, and TGF-β stored in the refrigerator is listed in Table 2 and that stored in the freezer is listed in Table 3. The concentration of these factors was stable for 1 month in the refrigerator (4° C) and for 3 months in the freezer (−20° C). Statistical analysis was performed by the ANOVA test.
Tear dynamics and corneal sensation
The average Schirmer test result was 6.3 ± 6.0 mm (Table 1), which suggested the presence of dry eye. The average Schirmer test with nasal stimulation was 7.2 ± 6.1 mm,
Case report
A 40-year-old Japanese man had bone marrow transplantation for the treatment of chronic myeloblastic leukemia on June 27, 1996. He developed chronic graft-versus-host disease with liver dysfunction 6 months after the bone marrow transplantation and suffered from dry eye and frequent rashes of the skin. He visited our department on July 10, 1997, reporting severe photophobia (painless) and red eye. He was barely able to open his eyes, and conjunctival injection was severe. The corneal epithelium
Discussion
We have reported the efficacy of autologous serum application for the treatment of persistent corneal epithelial defect in the patients with various underlying disease. Although there was no control in this study, the defects had persisted for at least 2 weeks, with an average of 6.8 months before treatment, and healing was achieved within 2 weeks in the “effective group” after initiation of autologous serum treatment. When we consider the partially effective groups as successful as well,
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Supported by the Japanese Ministry of Health and Welfare, Tokyo, Japan, and by the grant of Hightech Research Center at Tokyo Dental College, Ichikawa, Japan. Also supported by the Medical School Faculty and Alumni Grants of the Keio University Medical School, Tokyo, Japan.