Corneal Epithelialization Research Articles

Umbilical Cord Graft for Refractory Neurotrophic Keratopathy.

The purpose of this study was to evaluate whether an umbilical cord tissue graft (UCG) could promote reepithelialization in refractory cases of neurotrophic keratopathy, which failed traditional treatment modalities including amniotic membrane grafts. This retrospective case series included 3 eyes of 3 patients who underwent UCG placement for refractory stage 3 neurotrophic keratopathy. Records were reviewed to evaluate the clinical course including previous treatments, time to UCG dissolution, time to corneal epithelialization, and recurrence of epithelial defects. The time of a nonhealing epithelial defect before UCG placement ranged from 7.7 to 30 weeks (mean 21.0). UCG dissolution time ranged from 1.7 to 8.1 weeks (mean 5.0) compared with the previous failed amniotic membrane dissolution time of 0.3 to 1.6 weeks (mean 0.95). The time to complete epithelialization after UCG placement was 7.7 and 8.1 weeks, respectively, for the first 2 cases, whereas the third case did not fully epithelialize. Only 1 eye did not have recurrence of an epithelial defect. The maximum time of maintained epithelialization without recurrence ranged from 5 to 86 weeks (mean 42.7). Follow-up time was 37 to 108.1 weeks (mean 62.2) after first UCG placement. UCG may allow for longer retention time of tissue grafts, provide a mechanical barrier for protection, and aid in regeneration of the ocular surface. UCG may be an option for re-epithelialization in recalcitrant cases of neurotrophic keratopathy, after conventional treatments such as amniotic membrane grafts have failed.

Клинико-гистологические особенности заживления язв роговицы у кроликов

Ulcerative lesions of the cornea account for 47 to 70 % of all corneal diseases. In the case of a favorable course of corneal ulcers, opacification of varying degrees of intensity is formed. The currently existing methods of treating this pathology are not always effective, so the search for adequate models for experimental studies of new drugs is relevant. Purpose. To study the clinical and histological features of the healing of a corneal ulcer in rabbits. Material and methods. Animals were randomly divided into three groups of 29 rabbits (58 eyes) each. Rabbits of the first group received traditional treatment. Rabbits of the second and third groups underwent intrastromal administration of an antibiotic. The third group, against the background of traditional treatment, received a combination of intrastromal administration of an antibiotic into the cornea with PRP instillation. Animals underwent euthanasia on the 3rd, 5th, 10th, 14th and 21st days after infection of the cornea, 1 and 6 months after treatment. The results of the study showed that the timing of the decrease in the inflammatory response and the timing of the disappearance of purulent discharge in all three groups coincided (7th day) and amounted to 25.9 ± 5.7 %, 43.1 ± 6.5 % and 70.7 ± 6.0 % of cases, respectively. The number of epithelized ulcers by the 14th day of treatment in rabbits of the third groups is 3.4 and 1.7 times more than in rabbits of the 1st and 2nd groups, respectively. Histomorphological studies have shown that the inclusion of PRP in the complex therapy of corneal ulcers in the early stages of the inflammatory process in the cornea (the phase of alteration and exudation) leads to a reduction in the time of relief of the inflammatory process, accelerates the time of corneal epithelization. Keywords: corneal ulcer, PRP, intrastromal administration

Mini-Conjunctival Limbal Autograft (Mini-CLAU) Using Platelet-Rich Plasma Eye Drops (E-PRP): A Case Series.

The purpose of this study was to introduce a new method of limbal stem cell transplantation using autologous platelet-rich plasma (E-PRP) eye drops for unilateral total limbal stem cell deficiency. Patients with total unilateral limbal stem cell deficiency due to chemical burn underwent mini-conjunctival limbal autograft using autologous E-PRP drops. One small limbal block, measuring 2 × 2 mm, was harvested from the patients' contralateral healthy eye and transplanted to the diseased eye. All patients received E-PRP drops until achieving complete corneal epithelialization. Subsequent corneal transplantation was performed in eyes with significant stromal opacification. Corneal buttons obtained during corneal transplantation underwent immunohistochemistry for the evaluation of limbal stem cell markers (ABCG2 and P63). Visual acuity, epithelial healing, corneal clarity, and regression of corneal conjunctivalization/vascularization were evaluated after surgery. Ten patients with acid (n = 7) or alkali (n = 3) burn were included. The mean follow-up period was 21.7 ± 5.8 months (range, 12-32 months). Corneas were completely reepithelialized within 14.9 ± 3.5 days (range, 11-21 days). Corneal conjunctivalization/vascularization dramatically regressed 1 to 2 months after surgery in all cases, and corneal clarity considerably improved in 7 patients. In the 3 eyes with significant stromal opacification, subsequent optical penetrating keratoplasty was performed. The ocular surface was stable throughout the follow-up period in all eyes. BSCVA improved to 0.60 ± 0.0.32 and 0.46 ± 0.0.25 logMAR in eyes with and without corneal transplantation, respectively, at the final follow-up visit. ABCG2 and P63 markers were detected on corneal buttons after keratoplasty. Based on our clinical and laboratory findings, mini-conjunctival limbal autograft using E-PRP can be considered as a promising alternative to ocular surface reconstruction.

Andrographolide Inhibits Corneal Fibroblast to Myofibroblast Differentiation In Vitro.

Corneal opacification due to fibrosis is a leading cause of blindness worldwide. Fibrosis occurs from many causes including trauma, photorefractive surgery, microbial keratitis (infection of the cornea), and chemical burns, yet there is a paucity of therapeutics to prevent or treat corneal fibrosis. This study aimed to determine if andrographolide, a labdane diterpenoid found in Andrographis paniculate, has anti-fibrotic properties. Furthermore, we evaluated if andrographolide could prevent the differentiation of fibroblasts to myofibroblasts in vitro, given that the transforming growth factor beta-1(TGF-β1) stimulated persistence of myofibroblasts in the cornea is a primary component of fibrosis. We demonstrated that andrographolide inhibited the upregulation of alpha smooth muscle actin (αSMA) mRNA and protein in rabbit corneal fibroblasts (RCFs), thus, demonstrating a reduction in the transdifferentiation of myofibroblasts. Immunofluorescent staining of TGF-β1-stimulated RCFs confirmed a dose-dependent decrease in αSMA expression when treated with andrographolide. Additionally, andrographolide was well tolerated in vivo and had no impact on corneal epithelialization in a rat debridement model. These data support future studies investigating the use of andrographolide as an anti-fibrotic in corneal wound healing.

Effect of Lactoferin on the Rate of Defect Epithelization and Growth of Pathogenic Microflora in Corneal Erosions in the Experiment

Corneal lesions account for at least 1/4 of all ocular pathologies. This frequency is due to the fact that the outer eye’ shell is constantly exposed to adverse environmental factors and is quickly involved in the pathological process. The most spread disease is corneal erosion, the main treatment of which is the prevention of infectious complications. The widespread prevalence of corneal erosion and antibiotic resistance, which develops with the use of antibacterial drugs, led to the search for alternative therapies, one of which is lactoferrin.The purpose of our work was to study the effect of lactoferrin solution on the rate of corneal erosion epithelization in the experiment, to assess the effect of lactoferrin solution on the growth of pathogenic microflora against the background of corneal deepithelization in the experiment. An experimental model of corneal erosion was reproduced on 12 male chinchilla rabbits, divided into 2 groups (lactoferrin group and placebo group). Total scarification of the cornea was performed with an eye scalpel after preliminary epibulbar anesthesia with 0.4 % oxybuprocaine solution. Inoculations from the conjunctiva of the rabbits’ eyes to whey broth were carried out on the 0th, 3rd and 7th days of the experiment using sterile glass rods in the clinical diagnostic center of the city of Ryazan. Complete epithelialization of the cornea occurred in group 1 from 3 to 5 days, in group 2 — from 4 to 7 days. The average period of epithelialization in group 1 was 3.75 ± 0.62 days. In the second group — 5.42 ± 0.79 days. The use of a lactoferrin solution at a concentration of 0.5 mg/ml 3 time per day led to an acceleration of corneal epithelialization. In both groups, regardless of therapy, complete epithelialization of the cornea occurred by the 7th day. As a result of the experiment, there was no growth of microflora against the background of corneal de-epithelialization. Our data indicate that the use of a lactoferrin solution led to the suppression of the growth of pathogenic microflora, while placebo did not affect the growth of pathogenic microorganisms.

Transplantation of the oral mucosa epithelial layer in the treatment of corneal defects with limbal stem cell deficiency

BACKGROUND: Corneal epithelialization occurs due to proliferation and differentiation of limbal stem epithelial cells. Death of these cells or damage of its microenvironment leads to limbal stem cell deficiency. In bilateral total limbal damage (both eyes), autologues limbal stem cells transplantation becomes impossible. So, it is revalent to find new sources of autologous progenitor cells. One of such sources are buccal cells from cheek mucosa.
 AIM: To study the reparative effect of buccal cells in oral mucosa autologous epithelial layer in a mechanical limbal stem cell deficiency model.
 MATERIALS AND METHODS: The study was conducted on 7 Chinchilla rabbits (14 eyes). At the first stage, rabbits underwent bilateral total limbectomy and mechanical de-epithelialization of the cornea resulted in fibrovascular pannus development. Then, a full-layer flap of the cheek mucosa measuring 5 5 mm was taken, and epithelial layer was separated by 0.5% dispase solution. After superficial keratectomy to transparent layers, a layer of buccal epithelium was placed to the cornea and covered with a soft contact lens. In controls soft contact lens, was placed on the cornea. Temporary tarsorrhaphy was performed for 5 days. In the postoperative period, the area of the deepithelized surface, neovascularization and corneal transparency were evaluated.
 RESULTS: On the 7th30th day, a reduction of erosion was noted in experimental and control eyes, but the dynamics of recovery processes did not significantly differ. On day 60, the area of erosion in the experimental eyes was significantly less than in the control (p = 0.038). Recurrence of erosion was noted in 4 control and 3 experimental eyes.
 CONCLUSIONS: In our model of limbal stem cell deficiency, the use of a buccal epithelium layer did not reveal a pronounced reparative effect.

Транс-ФРК: резюме

Purpose. Based on more than 20 years of use of the excimer laser system "Profil-500" with a Gaussian broad beam, to demonstrate the expansion of the possibilities of laser correction of myopia. Material and methods. More than 10 thousand operations have been performed to correct myopia and complex myopic astigmatism. Postoperative follow-up included a survey on well-being, reaction to the exposure and the quality of the received vision. Statistical processing revealed and justified the distinctive features of the «Транс-ФРК®» methodology. Results. A reduction in the duration of postoperative pain syndrome has been achieved. Rapid and high-quality postoperative corneal epithelialization is observed, which reduces the likelihood of regression of the result obtained and the occurrence of postoperative haze. The effect of increasing the postoperative thickness of the cornea without refractive regression was revealed. The fact of unusually high visual acuity was found after the first stage of correction of very high myopia. The multifocal optical profile allows older patients to delay the need for spectacle correction of presbyopia by an average of 5 to 7 years. Conclusion. The Russian Trans-PRK technology is quite consistent with the term "breakthrough", allowing you to significantly expand the possibilities of laser correction of myopia. Methods of carrying out the operation are patented. The technique is individualized by the registration of the trademark «Транс-ФРК®». Keywords: laser correction of myopia, epithelialization, multifocality, Trans-PRK, corneal thickness, pain syndrome, spheroequivalent, visual acuity, keratotopogram.

Efficacy of Autologous Serum Gel in Neurotrophic Persistent Corneal Epithelial Defects Combined with Lagophthalmos.

To investigate the efficacy of autologous serum gel in patients with lagophthalmos combined with neurotrophic persistent corneal epithelial defects (PEDs). This is retrospective, case-series study enrolled 15 patients with lagophthalmos complicated by neurotrophic PEDs refractory to medical treatment including autologous serum eye drops. They were treated with autologous serum gel in conjunction with conservative treatment. The following information was collected from medical records: demographics, underlying diseases, and past ocular history. PEDs healing time was evaluated with visual acuity, visual analog scale (VAS) scores, esthesiometer scores, and the areas of the epithelial defects. Six men and nine women with a mean age of 63.3 ± 9.9years were included. The most common cause of the neurotrophic PEDs and lagophthalmos in this group was postherpetic infection (46.7%) and cerebral hemorrhage (26.7%) each. Two months following treatment with autologous serum gel, there was a reduction in the area of the epithelial defects (from 19.2 ± 9.9 to 0.6 ± 1.5mm2) and a significant improvement in best-corrected visual acuity (BCVA) (from 0.8 ± 0.5 to 0.5 ± 0.4 logMAR) and VAS scores (from 5.1 ± 1.1 to 2.1 ± 0.6) in 13 eyes (87%). Among the 11 completely healed eyes, the mean epithelial healing time was 3.2 ± 1.8weeks. Autologous serum gel reduces symptoms and promotes corneal epithelialization of refractory neurotrophic PEDs in patients with lagophthalmos. Therefore, it may be well tolerated and a beneficial addition in the management of neurotrophic PEDs in patients with lagophthalmos.

The use of an autologous platelet-rich fibrin (PRF) membrane for the treatment of deep corneal ulcers in dogs

The aim of this study was to evaluate the clinical efficacy of a platelet-rich fibrin (PRF) membrane, which is considered to be a new alternative surgical method in the treatment of vision-threatening corneal ulcers in dogs. Fourteen dogs (17 eyes) of various breeds and ages with deep corneal ulcers were treated surgically with a PRF membrane transplantation. The corneal ulcer of all the patients was closed with an autologous platelet-rich fibrin membrane. In the first 10 days after the operation, it was observed that the fibrin membrane partially melted, and corneal epithelialization and granulation tissue occurred in and around the ulcer area due to the graft material. Pain was significantly relieved, and conjunctival inflammation was noticeably improved. From the 20th day after the surgery, the granulation tissue was gradually cleaned. It was determined that all the eyes had vision. The most common complications after surgery were corneal pigmentation and fibrosis of varying severity. The use of autologous fibrin membranes is a safe and effective surgical alternative for the closure and healing of corneal ulcers. Our findings show that the autologous platelet-rich fibrin membrane is useful and effective in treating canine corneal deep ulcers.

In Situ-forming Collagen Hydrogels Crosslinked by Multifunctional Polyethylene Glycol as a Matrix Therapy for Corneal Defects: 2-Month Follow-up In Vivo.

We recently showed that in situ-forming collagen gels crosslinked through multifunctional polyethylene glycol (PEG) supported corneal epithelialization 7 days after treatment of lamellar keratectomy wounds. In this study, we aimed to evaluate the longer-term regenerative effects of this gel in animals. Corneal wound healing was assessed 60 days after lamellar keratectomy and gel treatment using slitlamp examination, optical coherence tomography (OCT), pachymetry, corneal topography, an ocular response analyzer, and tonometry. The corneas were evaluated for the presence of beta-tubulin, cytokeratin 3, zonula occludens-1, and alpha smooth muscle actin (SMA) markers. Gene expression of aldehyde dehydrogenase 3A1 (ALDH3A1), cluster of differentiation 31, CD163, alpha-SMA, hepatocyte growth factor, and fibroblast growth factor 2 (FGF-2) and protein expression of CD44 and collagen VI were evaluated. Intraocular pressure, corneal thickness, and hysteresis for the corneas treated with collagen-PEG gels did not significantly change compared with the saline group. However, placido disk topography revealed greater regularity of the central cornea in the gel-treated group compared to the saline group. The gel-treated group exhibited a lower degree of epithelial hyperplasia than the saline group. Immunohistochemical and gene expression analysis showed that the gel-treated corneas exhibited lower alpha-SMA expression compared with the saline group. CD163 and CD44 were found to be elevated in the saline-treated group compared with normal corneas. The in situ-forming collagen-PEG gel promoted epithelialization that improved central corneal topography, epithelial layer morphology, and reduced expression of fibrotic and inflammatory biomarkers after 60 days compared to the saline group.

Modification of Collagen Film via Surface Grafting of Taurine Molecular to Promote Corneal Nerve Repair and Epithelization Process.

Corneal defects can seriously affect human vision, and keratoplasty is the most widely accepted therapy method for visual rehabilitation. Currently, effective treatment for clinical patients has been restricted due to a serious shortage of donated cornea tissue and high-quality artificial repair materials. As the predominant component of cornea tissue, collagen-based materials have promising applications for corneal repair. However, the corneal nerve repair and epithelization process after corneal transplantation must be improved. This research proposes a new collagen-based scaffold with good biocompatibility and biological functionality enhanced by surface chemical grafting of natural taurine molecular. The chemical composition of collagen-taurine (Col-Tau) material is evaluated by Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy, and its hydrophilic properties, light transmittance, swelling performance and mechanical tensile properties have been measured. The research results indicate that the Col-Tau sample has high transmittance and good mechanical properties, and exhibits excellent capacity to promote corneal nerve cell growth and the epithelization process of corneal epithelial cells. This novel Col-Tau material, which can be easily prepared at a low cost, should have significant application potential for the treating corneal disease in the future.

Palliative Efficacy of Intrastromal Amniotic Membrane Procedure in Symptomatic Bullous Keratopathy Patients.

Objectives:To evaluate the palliative efficacy of the intrastromal human amniotic membrane (hAM) surgery technique in patients with symptomatic bullous keratopathy and limited visual potential.Materials and Methods:The study was carried out retrospectively by reviewing the medical data of 10 patients with poor visual prognosis who underwent intrastromal hAM surgery due to bullous keratopathy-related severe pain. Visual acuity, surgical indication, epithelization time, preoperative and postoperative pain scores, as well as anterior segment optical coherence tomography images and anterior segment photographs were obtained from the medical records.Results:Ten patients (6 females/4 males) were included in the study. Nine patients underwent surgery for pseudophakic bullous keratopathy and glaucoma, and 1 patient due to graft failure and glaucoma. The mean time for corneal epithelization was 27.10±13.05 days (range, 10-50), while the mean follow-up time was 37.5±1.6 months (range, 36-39.2). Subjective pain score improved in all patients after surgery. Suture-induced keratitis occurred during follow-up in one patient and was controlled with medical treatment.Conclusion:Intrastromal amniotic membrane surgery may be an alternative to keratoplasty for pain palliation in patients with limited visual prognosis after corneal transplantation when donor tissue is scarce. With this method, hAM remains on the ocular surface longer, and superficial stromal excision is believed to provide a more regular ocular surface and extend the asymptomatic period.

Эффективность лечебных мягких контактных линз при эпителиально-эндотелиальной дистрофии роговицы

Purpouse is to evaluate the effectiveness of therapeutic contact lenses (TCL) in epithelial-endothelial corneal dystrophy (EEDR). Material and methods. We observed 60 patients (70 eyes) with EEDR. Hydrophilic TCL with complex preparations with antioxidant and regenerative effects were used while treating EEDR. All patients underwent visometry, pneumotonometry, biomicroscopy, autorefractometry, ophthalmoscopy. Results. With EEDR, patients complained of a sensation of a foreign body in the eyes and sharp pain in 91.4 % (64 eyes) of cases, redness in 100 % (70 eyes), photophobia in 100 % (70 eyes), tearing in 100 % (70 eyes) and decreased vision in 97.1 % (68 eyes) of cases. Therapeutic contact lenses (TCL) helped to relieve pain with 91.4 % (64 eyes) of patients. TCL contributed to corneal epithelialization in 94.3 % (66 eyes) of cases. TCL helped to maintain the inherent moisture of the cornea in 97.1 % (68 eyes) of cases by reducing the evaporation of moisture from the surface of the cornea. Conclusion. The use of a therapeutic contact lens in patients with EDRD made it possible to significantly relieve pain in 91.4 % of cases, but increased the healing time by means of corneal epithelialization in 94.3 % of patients. Keywords: epithelial and endothelial corneal dystrophy, bullous keratopathy, therapeutic contact lenses.

Effect of Platelet-Riched Plasma on Corneal Epithelium Regeneration during Its Chronic Erosion (Experimental Study)

Relevance. In a number of pathological conditions accompanied by defects of the basal membrane, such as chemical or thermal burn, mechanical trauma, Schegren’s syndrome, herpetic keratitis processes of corneal epithelization are slowed down, and sometimes epithelization does not occur at all. Slow epithelization or its complete absence creates conditions for infection, thinning, and sometimes perforation of the cornea. That is why the problem of chronic corneal erosions is very relevant. The most perspective method of treatment is the use of autologous platelet-riched plasma (PRP). Presence of platelet growth factors, adhesive molecules and cytokines in PRP allows to use it for acceleration of regeneration of corneal defects, and the presence of live platelets allows to refer this procedure to autologous cell transplantations.Objective: To evaluate the clinical and morphological features of corneal epithelium regeneration in response to the application of PRP in conditions of experimental chronic corneal erosion (ECCE).Materials and methods. Researches were carried out on 12 rabbits of Chinchilla breed (24 eyes). At first stage the model of ECCE was reproduced for all animals: local ultraviolet (UV) irradiation with the exposure time of 45 min. on the preliminary de-epithelized corneal surface. At the second stage all animals under study were divided into three groups (4 rabbits in each group). I-st main group (MG) was instillated with PRP at a rate of 1 drop / 1 min within 10 minutes (total of 10 drops) once, in the II MG treatment was carried out according to the above method, every day for 5 days. In the control group (CG) PRP treatment was not applied.Results. 45-min. UV irradiation causes persistent ECCE up to 30 days of the experiment and reverts only after surface vessels are ingrowed in the affected area. Single use of PRP has insufficient therapeutic effect. Instillation within 5 days accelerates the cornea reparative regeneration in ECCE conditions. The absence of epithelial defect, newly formed vessels and corneal clouding was registered on the 9th day. Histologically, on the 30th day a normal multilayer non-squamous epithelium was found, while the stroma had an organized structure with no signs of inflammation.Conclusions. Therapeutic effect of PRP in ECCE conditions is based on reforming of the normal «adhesion complex» between epithelium, olfactory membrane and multifactor stimulation of reparative regeneration due to growth factors located in it, adhesive molecules and cytokines, as a result of which the typical corneal epithelium is restored.

Evaluation of the recurrence rate and complications for pterygium treated with limbal conjunctival autograft

AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y. METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients (142 males and 122 females) with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24y. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12, and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated. RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. Five eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo. CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.

Safety and feasibility of subconjunctival injection of mesenchymal stem cells for acute severe ocular burns: A single-arm study

PurposeTo investigate the safety and feasibility of topical injection of bone marrow derived mesenchymal stem cells (BM-MSCs) in acute severe ocular burns. MethodsIn this open-label，single-arm study, subconjunctival injection of allogenic BM-MSCs combined with standard treatment was given to 16 patients with acute severe ocular burns (Dua's grade IV to VI) within 2 weeks after injury. The primary outcome was efficacy rate which referred to the proportion of complete corneal epithelialization patients without perforation. The secondary outcome was safety, visual acuity, the number of symblephara, and elevated intraocular pressure. ResultsOne patient was lost to follow-up. During the follow-up period, no corneal perforation was developed. Complete corneal epithelialization was noted 8 (ranged 4–10 weeks) weeks after treatment in 13 eyes (81.3%). The efficacy rate was 87.5% (95% confidence interval, CI: 61.7–98.4). Hypopyon was detected and later well controlled in 1 eye. Partial or total limbal stem cell deficiency (LSCD) was noted in all eyes. Improvement of visual acuity was achieved in 5 out of 16 eyes (31.3%). Seven eyes’ visual acuity was reached 0.1. Symblepharon with varied severity was noted in 5 eyes. Two eyes had elevated intraocular pressure. ConclusionsThis study confirms the safety of subconjunctival injection of BM-MSCs as an innovative and convenient procedure in ocular burns. The overall result is promising considering the absence of perforation, the low severity of symblepharon and visual acuity improvement.

Оценка эффективности инновационного подхода к барьерной амниопластике в хирургическом лечении первичного прогрессирующего птеригиума

The article evaluates the effectiveness of the proposed new method of barrier amnioplasty in the surgical treatment of primary progressive pterygium. The study involved 40 patients with primary progressive pterygium, who, depending on the method of barrier amnioplasty, were divided into 2 groups. Patients of group 1 underwent barrier amnioplasty in the limbus area, group 2 – in the area of plica semilunaris. Comparison of the methods was carried out using standard examination methods, as well as cytological examination and pH-metry of the lacrimal fluid. The developed method of amnioplasty in the area of the plica semilunaris has shown high efficiency: the time of corneal epithelialization was reduced by 1.7 times and the vitalization of the amnion by 1.5 times. An uncomplicated postoperative course of inflammatory and regenerative reactions made it possible to reduce the frequency of recurrence of pterygium, reduce the degree of postoperative astigmatism, and improve visual acuity

Experimental Studies and the Search for New Innovative Approaches to Treat Dry Eye Disease

Introduction and purpose. The main manifestation of eyelids, tear ducts, and orbits disorders is a dry eye disease considered as a serious disease that affects the quality of life. Nowadays, one in ten people worldwide faces this disease. Increased workload, development of multimedia technologies, hypodynamia, and environmental degradation are the main modern causes of the disease. Material and methods. In this work, we used an experimental model of dry eye in rats with the development of inflammation of the anterior surface of the eye. Alkali burns were used to develop inflammation. A fluorescein test performed immediately after alkaline erosion and on days 1, 5, and 10 after burns revealed a gradual increase in corneal epithelialization and vascularization. Results. One day after induction of inflammation, there was a dramatic and statistically significant increase in tear production in experimental rats. By the seventh day, tear production declined to the control level with a subsequent tendency to decrease tear production. Conclusions. In the group of rats with inflammation of the anterior surface of the eye that received polarized red-light therapy, there was no significant decrease in tear production on day 7, which may be indicative of a possible anti-inflammatory effect of light therapy under these conditions.

The effect of cultured autologous oral mucosal epithelial cells on ocular surface reconstruction.

Oral epithelial cells were recently shown to be able to differentiate into corneal epithelium, and the efficacy of cultured autologous oral mucosal epithelial cells (CAOMEC) has been suggested by the presence of epithelium replacement. Therefore, the aim of this study was to evaluate the treatment outcome in limbal stem cell deficiency (LSCD) by adding CAOMEC to regular amniotic membrane (AM) treatment. Eyes with LSCD were randomized to two groups to undergo either autologous oral mucosal epithelial cell sheet (CAOMECS) combined with AM transplantation (A group) or AM transplantation alone (B group). Clinical outcome measures were corneal epithelium healing, best corrected visual acuity, symblepharon, corneal transparency, corneal neovascularization and ocular surface inflammation. The normal corneal epithelialization rate in group A (73.33%) was higher than that in group B (35.48%), and the average healing time was shorter (3.45 ±2.12 weeks vs. 4.64 ±1.63 weeks). The symblepharon in the above two groups was improved in the first 3 months after surgery, but after 6 months, part of the B group had recurrence. In improving corneal transparency, group A has obvious advantages. Corneal neovascularization (CNV) was improved to some extent in the first 3 months after surgery, but group A (1.47 ±0.64) was better than group B (1.94 ±0.85) after 6 months. Both groups can improve the inflammatory state to some extent. The transplantation of CAOMECS offers a viable and safe alternative in the reconstruction of a stable ocular surface. The effect is better than that of traditional AM transplantation, mainly in promoting corneal epithelialization, improving ocular surface structure, and reducing fiber and vascular infiltration.

Development and evaluation of the effectiveness of photodynamic therapy in inflammatory diseases of the ocular surface

Relevance. In the treatment of inflammatory diseases of the ocular surface, in order to achieve high efficiency in the shortest possible time, it is necessary for the therapy to be comprehensive. Today, in addition to traditional treatment methods, new technologies based on the use of low-energy lasers, which have high biological activity, are spreading.
 Aim. To improve the treatment results of the inflammatory diseases of the ocular surface by implementing photodynamic therapy (PDT) in experiment and clinic, using domestic equipment and elaborating optimal energetic parameters of laser irradiation.
 Methods. Objects of research: 130 nonlinear sexually mature rats weighing 150 grams contained in standard vivarium conditions and 110 eyes of patients with inflammatory eye diseases. Carrying out the investigation, experiments on animals, clinical and functional examination results of patients, and statistical analysis were taken into consideration.
 Results. A methodology for complex treatment of inflammatory diseases of the ocular surface was developed (with inclusion of PDT by the laser therapy device Vostok), based on experimental data and confirmed by clinical and functional ocular indices. PDT helps to increase the effectiveness of treatment, which is manifested by accelerated tissue regeneration, restoration of corneal transparency, increase of visual function in 86.7%, and reduction of treatment terms to 6 days.
 Conclusions. Anti-inflammatory and regenerative effectiveness of the proposed complex treatment of inflammatory diseases of the ocular surface with the PDT use was established: improvement in the clinical picture of conjunctivitis and keratitis was revealed, manifested by increase in corneal epithelization.