University of Auckland, Department of Ophthalmology, New Zealand National Eye Centre, New Zealand.
University of Auckland, Department of Ophthalmology, New Zealand National Eye Centre, New Zealand.
Adv Drug Deliv Rev. 2018 Feb 15;126:162-176. doi: 10.1016/j.addr.2018.01.006. Epub 2018 Jan 31.
In order to maintain a smooth optical surface the corneal epithelium has to continuously renew itself so as to maintain its function as a barrier to fluctuating external surroundings and various environmental insults. After trauma, the cornea typically re-epithelializes promptly thereby minimizing the risk of infection, opacification or perforation. A persistent epithelial defect (PED) is usually referred to as a non-healing epithelial lesion after approximately two weeks of treatment with standard therapies to no avail. They occur following exposure to toxic agents, mechanical injury, and ocular surface infections and are associated with significant clinical morbidity in patients, resulting in discomfort or visual loss. In the case of deeper corneal injury and corneal pathology the wound healing cascade can also extend to the corneal stroma, the layer below the epithelium. Although significant progress has been made in recent years, pharmaco-therapeutic agents that promote corneal healing remain limited. This article serves as a review of current standard therapies, recently introduced alternative therapies gaining in popularity, and a look into the newest developments into ocular wound healing.
为了保持光滑的光学表面，角膜上皮必须不断更新，以维持其作为屏障的功能，防止外界环境和各种环境因素的干扰。在创伤后，角膜通常会迅速重新上皮化，从而最大限度地降低感染、混浊或穿孔的风险。持续性上皮缺损（PED）通常是指在经过大约两周的标准治疗后，上皮病变仍未愈合。它们发生在接触有毒物质、机械损伤和眼表感染后，与患者的显著临床发病率相关，导致不适或视力丧失。在更严重的角膜损伤和角膜病变的情况下，伤口愈合级联反应也可以扩展到上皮下方的角膜基质层。尽管近年来取得了重大进展，但促进角膜愈合的药物治疗仍然有限。本文综述了目前的标准治疗方法、最近越来越受欢迎的替代治疗方法，以及对眼表伤口愈合最新发展的探讨。
