Cocaine-Assisted Epithelial Debridement for the Treatment of Anterior Basement Membrane Dystrophy

Sayegh, Rony R.; Kouyoumjian, Paul B.; Vedula, Geetha G.; Nottage, Jennifer M.; Nirankari, Verinder S.

doi:10.1097/ico.0b013e318288ad4d

Cited by 11 publications

(10 citation statements)

References 20 publications

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“…The cohort was too small to provide meaningful conclusions. Sayegh et al applied cocaine to the cornea – in a manner similar to alcohol – to facilitate ED 71. Benitez-del-Castillo et al combined 250 µg/mL of substance P-derived peptide with 1 µg/mL of insulin-like growth factor that they applied as an eye drop four times a day to a single patient for 2 months 72.…”

Section: Introductionmentioning

confidence: 99%

<p>Recurrent corneal erosion: a comprehensive review</p>

Miller¹,

Hasan²,

Simmons³

et al. 2019

OPTH

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Purpose To comprehensively review the literature regarding recurrent corneal erosion (RCE) and to present treatment options and recommendations for management. Overview RCE usually presents with sharp, unilateral pain upon awakening, in an eye with an underlying basement membrane dystrophy, prior ocular trauma, stromal dystrophy or degeneration, or prior surgery for refractive errors, cataracts, or corneal transplantation. Making the correct diagnosis requires a careful slit-lamp examination of both eyes coupled with a high degree of suspicion. Several treatments are commonly used for RCE but new therapies have been introduced recently. Conservative treatment consists of antibiotic and preservative-free lubricating drops, with topical cycloplegics and oral analgesics to control pain. Patients who are unresponsive to these therapies may benefit from therapeutic bandage contact lenses (BCL). Newer therapies include oral matrix metalloproteinase (MMP) inhibitors, blood-derived eye drops, amniotic membrane graft application, and judicious application of topical corticosteroids. Once the epithelium is healed, a course of hypertonic saline solution and/or ointment can be used. Surgical procedures may be performed in patients who fail conservative therapy. Punctal occlusion with plugs increases the tear film volume. Epithelial debridement with diamond burr polishing (DBP), anterior stromal puncture (ASP), or alcohol delamination should be considered in selected patients. DBP can be used for patients with basement membrane dystrophies and is the preferred treatment overall due to a low recurrence rate. ASP can be used for erosions outside the central visual axis. Excimer laser phototherapeutic keratectomy is an attractive option in eyes with central RCE since it precisely removes tissue while preserving corneal transparency. In patients with RCE who are also candidates for refractive surgery, photorefractive keratectomy can be considered. Summary Newly introduced therapies for RCE enable therapy to be individualized and lower the recurrence rate.

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Section: Introductionmentioning

confidence: 99%

<p>Recurrent corneal erosion: a comprehensive review</p>

Miller¹,

Hasan²,

Simmons³

et al. 2019

OPTH

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“…Firstly, an abnormal or deficient basal membrane caused by corneal melting due to local inflammation hindered epithelial healing, resulting in defective cellular adhesion and recurrent breakdown of the epithelium [10]. Secondly, the inflammatory cells and stromal keratocytes in a distinct, preexisting inflammatory microenvironment restrained epithelial healing by secreting proinflammatory cytokines and proteolytic enzymes [3].…”

Section: Discussionmentioning

confidence: 99%

Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

Zhang

Wang

Jia

et al. 2016

Journal of Ophthalmology

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Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT) in treating nonhealing corneal ulcers. Material and Methods. Eleven patients (11 eyes) with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded. Corneal status was inspected by the laser scanning confocal microscopy and anterior segment optical coherence tomography (AS-OCT). Results. The primary diseases were herpes simplex keratitis (8 eyes), corneal graft ulcer (2 eyes), and Stevens-Johnson syndrome (1 eye). All epithelial flaps were intact following surgery, without shedding or displacement. Mean ulcer healing time was 10.8 ± 3.1 days, with a healing rate of 91%. Vision significantly improved from 1.70 to 0.82 log MAR (P = 0.001). A significant decrease in inflammatory cell infiltration and corneal stromal edema was revealed 2 months postoperatively by confocal microscopy and AS-OCT. Corneal ulcer recurred in 1 eye. None of the patients developed major complications. Conclusion. Active pedicle epithelial flap transposition combined with AMT is a simple and effective treatment for nonhealing corneal ulcers.

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“…The opacities could lead to the disruption of visual acuity, but their location and severity determine the final outcomes. [ 12 ] The onset seems to be earlier in homozygote than in heterozygote patients. [ 13 ] GCD2 is related to TGFB1 gene mutation, is mapped to chromosome 5q, and has an autosomal dominant pattern.…”

Section: Introductionmentioning

confidence: 99%

“…[ 13 ] GCD2 is related to TGFB1 gene mutation, is mapped to chromosome 5q, and has an autosomal dominant pattern. [ 12 ] Histologically, GCD2 patients have both superficial hyaline granular deposits and deep amyloid lattice deposits. The hyaline granules and amyloid lattice lines are stained with Masson’s trichrome and Congo red, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Rare stromal corneal dystrophic diseases in Oman: A clinical and histopathological analysis for accurate diagnosis

Reda

El-Din

2020

Oman J Ophthalmol

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INTRODUCTION: Corneal dystrophy (CD) encirclements a heterogeneous group of genetically determined corneal diseases. Many features still remain unknown. AIM: The purpose of this study was to highlight the clinical and the histopathological aspects of rare stromal CDs and to assess the clinical and the histopathological roles in their diagnosis. PATIENTS AND METHODS: This study incorporated 10 eyes of six patients, clinically diagnosed as follows: four patients with bilateral lattice stromal CD (8 eyes) and two patients, each one eye, one with macular and the other with granular-type CD. Histopathological examination with applications of many special stains was done in four eyes (4 patients) after penetrating keratoplasty. RESULTS: The histopathological examination was in concordance with the clinical diagnosis of three examined corneas and revealed first eye with lattice dystrophy, second eye with macular dystrophy, and third eye with granular dystrophy. The fourth examined cornea was not that in concordance with the clinical diagnosis of lattice CD as it showed mixed stromal CD patterns of granular, macular, and lattice types. CONCLUSION: Histopathological assessment of corneal dystrophy cases, subjected to keratoplasty is recommended to avoid missing cases with mixed stromal corneal dystrophy. Also, using low magnification slit lamp alone in the clinical assessment of the corneal opacity appeared to be limited mode and thus, the imaging corneal methods such confocal microscopy and high-definition optical coherence tomography are recommended for future cases especially in cases with unclassic query diagnosis.

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Cocaine-Assisted Epithelial Debridement for the Treatment of Anterior Basement Membrane Dystrophy

Abstract: Topical cocaine-assisted epithelial debridement offers a simple and inexpensive method for treating patients with ABMD who experience recurrent corneal erosions and/or irregular astigmatism resulting in decreased visual acuity.

Cited by 11 publications

References 20 publications

<p>Recurrent corneal erosion: a comprehensive review</p>

<p>Recurrent corneal erosion: a comprehensive review</p>

Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

Rare stromal corneal dystrophic diseases in Oman: A clinical and histopathological analysis for accurate diagnosis

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