A new method for treatment severe forms of dry keratoconjunctivitis (preliminary results)

Abstract

The aim is to improve the treatment method of severe keratoconjunctivitis sicca (KCS) forms using designed soft contact lenses (SCL).
 Material and methods. An original SCL of silicone hydrogel material with individual optical power, consisting of a non-through depot filled with 0.05% Cyclosporin A (CyA) was designed. The therapeutic CyA saturated SCL was used in 5 patients (1 male and 4 females; 7 eyes) aged from 34 to 66 years, with severe KCS, who were constantly wearing them for 7-14 days. Patients additionally instilled hyaluronic acid containing non-preserved artificial tears up to 6 times a day. Standard ophthalmic examination, Schirmer test, tear break-up-time test, tests using vital dyes (assessed using the Oxford scale), tear osmolarity measurements (TearLab System, USA), tear pH measurement by a highly sensitive litmus test, conjunctival culture, measurement of the interpalpebral fissure width were carried out, the ocular surface disease index (OSDI) was determined. Treatment results were assessed in 1 week, 1 month, and 3 months since the SCL wear start.
 Results. The use of therapeutic CyA saturated SCL allows to achieve complete corneal epithelization, and helps to reduce inflammation within the time from 1 week up to 1 month, significantly reducing the treatment timeframe of severe forms of KSC in comparison to standard therapy.
 Conclusion.The developed treatment method for severe forms of the KCS consists in using specifically designed therapeutic SCL which provides an even CyA 0.05% release on the ocular surface, while instilling non-preserved artificial tears. Preliminary results show a high efficacy of this method in terms of reducing corneal epithelization time up to 1 week-1 month and resolving inflammation on the ocular surface.