Novel Treatment Options for Corneal Edema

Abstract

Introduction: The current treatment of corneal edema is limited to hyperosmotic saline mixtures. Usually the therapy consists of treatment with hypertonic 5% NaCl eye drops or 6% eye ointment. However, these only remain on the cornea for a short time because they are quickly removed by the tear film and blinking. This problem is partly addressed by adding hyaluronic acid to some pharmaceuticals. In this work, Sovermol as a carrier oil supplied with osmotically active substances, honey, icing sugar, Substance C188 and Prevor® substance X were investigated in an experimental setting as therapeutics for corneal edema. Material and Methods: In the Ex vivo Eye irritation Test (EVEIT), corneas can be examined under defined and stable biochemical conditions without blinking. Corneal edema can be simulated and examined using ultrasound pachymetry and Optical Coherence Tomography (OCT). Thus, we investigated the deswelling effect of the substances described above on 23 EVEIT corneas. Results: The mixtures, examined in this study, showed a significant reduction of corneal edema especially mixtures of Sovermol with Substance C188 were very promising as a new approach to treatment of corneal edema. As reference substance for corneal edema treatment ODM5® was used. Other mixtures, especially Honey and Prevor® substance X in DOL showed a sufficient reduction of corneal edema, while also damaging the corneal epithelium. While the mixture of DOL and powder sugar showed an increased corneal thickness and damaged Epithelium. Conclusion: The therapy of corneal edema with osmotically active substances as investigated here is a promising treatment for corneal edema. However, further pharmacological development is needed for application in patients.