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治疗性高渗性软性角膜接触镜在干燥综合征中的应用

Therapeutic Hyper-CL soft contact lens in Sjögren's syndrome.

作者信息

Romano Vito, Romano Davide, Semeraro Paolo, Forbice Eliana, Iaria Antonio, Pizzolante Teodoro, Frassi Micol, Franceschini Franco, Semeraro Francesco

机构信息

Eye Clinic, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

Rheumatology and Clinical Immunology Unit, ASST Spedali Civili of Brescia, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

出版信息

Am J Ophthalmol Case Rep. 2022 Aug 19;28:101685. doi: 10.1016/j.ajoc.2022.101685. eCollection 2022 Dec.

Abstract

PURPOSE

To report increased corneal bioavailability of allogenic serum when used in combinations with Therapeutic Hyper-CL™ soft contact lens in a patient with severe Sjögren's syndrome-associated dry eye.

OBSERVATIONS

A 57-year-old woman with a medical history of bilateral severe Sjögren's syndrome-associated dry eye and previous amniotic membrane patch for autoimmune corneal perforation in her left eye was referred for left eye recurrence of progressive melting and pending perforation. After manual corneal trephination, full thickness transplant and sutured amniotic membrane patch, a Therapeutic Hyper-CL™ soft contact lens (EyeYon Medical, Ness Tziona, Israel) was fit. The patient was commenced in the left eye with topical corticosteroid, antibiotic, and allogenic serum eye drops. In the right eye the patient had silicone hydrogel bandage contact lens and was under same treatment of the left eye for previous endothelial keratoplasty. In order to evaluate the efficacy and increased corneal availability of drugs provided by Therapeutic Hyper-CL™ compared with silicone hydrogel soft contact lens, anterior segment OCT was performed.

CONCLUSIONS AND IMPORTANCE

The anterior segment OCT showed a thicker meniscus of fluid and possibly subsequent increase of trophic factors bioavailability in left eye compared with right eye. Therefore, in case of severe and refractory dry-eye disease the combination of Therapeutic Hyper-CL™ and serum eye drops may be representing a valid therapeutic approach.

摘要

目的

报告在一名患有严重干燥综合征相关性干眼的患者中,异体血清与Therapeutic Hyper-CL™软性接触镜联合使用时角膜生物利用度增加的情况。

观察结果

一名57岁女性,有双侧严重干燥综合征相关性干眼病史,左眼曾因自身免疫性角膜穿孔接受羊膜贴片治疗,现因左眼渐进性溶解复发且即将穿孔前来就诊。在进行手动角膜环钻、全层移植和缝合羊膜贴片后,佩戴了Therapeutic Hyper-CL™软性接触镜(以色列内斯齐奥纳的EyeYon Medical公司生产)。患者左眼开始使用局部皮质类固醇、抗生素和异体血清滴眼液。右眼患者佩戴硅水凝胶绷带接触镜,因之前接受过内皮角膜移植术,接受与左眼相同的治疗。为了评估Therapeutic Hyper-CL™与硅水凝胶软性接触镜相比提供的药物的疗效和角膜可用性增加情况,进行了眼前节光学相干断层扫描(OCT)。

结论与意义

眼前节OCT显示,与右眼相比,左眼的液体半月板更厚,可能随后营养因子的生物利用度增加。因此,在严重难治性干眼疾病的情况下,Therapeutic Hyper-CL™与血清滴眼液联合使用可能是一种有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b609/9424940/aa4d6eec2847/gr1.jpg

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