Spontaneous Persistent Epithelial Defects After Cataract Surgery

Nishida, Teruo; Yagi, Jumpei; Fukuda, Masahiko; Kusube, Tôru; Otori, Toshifumi

doi:10.1097/00003226-198706010-00004

Cited by 17 publications

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“…Fibronectin eye drops have been used to treat a variety of conditions with persistent epithelial defects. Epithelial defects occurring in herpetic keratitis, trophic corneal ulcers and after cataract surgery have responded to fibronectin drops when used in an open labeled study (Nishida et al, 1985;Nishida et al, 1983;Nishida et al, 1987). An alternative explanation is suggested by an animal study showing that albumin eye drops were as effective as fibronectin in the treatment of persistent epithelial defects (Boisjoly et al, 1987).…”

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confidence: 99%

Clinical Measures to Promote Corneal Epithelial Healing

Pfister¹

1992

Acta Ophthalmologica

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It is necessary to know the specific pathobiology of a persistent epithelial defect to determine the strategy to be employed to assist in its repair. Lid position and function must be normal and any deficiency in the quantity and quality of the tears enhanced by tear preparations and closure of the lacrimal canaliculi. Adverse drug effects must be eliminated. Multiple corneal punctures and excision of reduplicated basal lamina have virtually eliminated the problem of recurrent corneal erosions. Control of any inflammatory process also speeds healing. Vitamin supplements, especially A, reverse defects associated with xerophthalmalia. In any of these diseases, mechanical treatments consisting of soft contact lenses for persistent epithelial defects and collagen shields for the delivery of antibiotics or steoids to the eye may be employed. Tarsorraphy relieves the problem of persistent epithelial defects in neurotrophic keratitis and a variety of other conditions characterized by persistent surface breakdown. Preliminary data from open label studies of epidermal grcwth factors and fibronectin are encouraging but not yet conclusive.

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confidence: 99%

Clinical Measures to Promote Corneal Epithelial Healing

Pfister¹

1992

Acta Ophthalmologica

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“…A posterior capsular opacity developed in two eyes which needed to be followed-up to assess the progression. Although, no corneal incision-related complications, such as corneal decompensation or recurrent erosion, were experienced, long-term follow-up is needed 21,22. It is acknowledged that there are other permutations of the phacovitrectomy techniques, that may be preferable for certain surgeons.…”

Section: Discussionmentioning

confidence: 99%

A Phacovitrectomy with a Clear Corneal Incision for a Full-Thickness Macular Hole

Kim

2006

Korean J Ophthalmol

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PurposeTo describe the results of a pars plana vitrectomy, combined with phacoemulsification, using a sutureless, superotemporal, clear corneal incision for patients with a macular hole.MethodsThis study reviewed the records of 22 patients (22 eyes) who underwent a phacoemulsification with the insertion of an acrylic intraocular lens, using a 3.2 mm superotemporal clear corneal incision and a pars plana vitrectomy with an internal limiting membrane peeling in one session, for the treatment of a macular hole.ResultsAll 22 patients had their macular holes closed using the combined surgical procedures. The mean preoperative visual acuity was 0.086, and the mean postoperative visual acuity was 0.173. This improvement was statistically significant (paired Student's t-test, p<0.05). No patients developed posterior capsular opacity, retinal detachment, or a cystoid macular edema. The surgically induced astigmatism (SIA) was 0.808 diopters (0.808±0.761) two months after surgery.ConclusionsCombining cataract surgery with vitrectomy can achieve visual rehabilitation in the early postoperative period without requiring post-vitrectomy cataract surgery. A sutureless clear corneal incision, used in this procedure, can minimize the SIA and promote postoperative wound healing. If sutureless, transconjunctival, pars plana vitrectomy can be used more widely in the future, then the simplified, combined cataract surgery using a small clear corneal incision will also become more common, hence decreasing operation time, and hastening postoperative recovery.

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“…Patients having plasmin in their tear fluid may benefit from plasmin inhibitor therapy. Additionally, fibronectin, topically administered to enhance epithelial re-surfacing (Fujikawa 1981 ;Nishida et al 1985Nishida et al , 1987Harnisch & Sinha 1985) can be protected against the degrading activity of plasmin by a plasmin inhibitor such as aprotinin (Salonen et al 1987). Topical use of aprotinin may also be useful because plasmin is known to activate latent collagenase in the cornea (Rerman etal.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been reported to improve corneal epithelialization in patients with epithelial defects associated with trophic ulcer. herpetic keratitis, trigeminal nerve disturbance and cataract surgery (Nishida et al 1983;Harnisch & Sinha 1985;Nishida et al 198.5;Nishida et al 1987). However, in some models, fibronectin has been ineffective (Jumblatt & Neufeld 1986).…”

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Elevation of tear fluid plasmin in corneal disease

Tervo¹,

Salonen

Vahen

et al. 1988

Acta Ophthalmologica

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Plasmin concentration was determined in tear fluid from 76 eyes showing corneal epithelial disorders, such as corneal ulcers and erosions due to trauma or contact lens wear. Nearly 70% of the eyes with corneal disease had plasmin in their tear fluid, whereas plasmin was present in only 20% of the eyes in a control group of 50 eyes. Re-examination of the plasmin positive control eyes revealed conjunctival bacterial growth or mild subclinical viral infection in most cases. We conclude that plasmin is released into the tear fluid in the presence of corneal or conjunctival lesions or infections, suggesting a pathogenic role of plasmin in these disorders. The significance of the occurrence of plasmin in tear fluid during corneal wound healing is discussed.

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Spontaneous Persistent Epithelial Defects After Cataract Surgery

Cited by 17 publications

References 0 publications

Clinical Measures to Promote Corneal Epithelial Healing

Clinical Measures to Promote Corneal Epithelial Healing

A Phacovitrectomy with a Clear Corneal Incision for a Full-Thickness Macular Hole

Elevation of tear fluid plasmin in corneal disease

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