Chaum Edward, Kim Dooho Brian, Kane Steven, Swann Forrest B, Waite Aaron, Wade Lloyd R, Riemann Christopher D, Snyder Michael E
Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN.
Professional Eye Associates, Dalton, GA.
Cornea. 2024 Aug 1;44(7):886-895. doi: 10.1097/ICO.0000000000003651.
Anterior stromal puncture is an inexpensive and widely used technique at the slit lamp to treat recurrent corneal erosions (RCE), common sequelae of corneal abrasions, trauma, and epithelial basement membrane dystrophies (EBMDs). The purpose of this study was to determine safety of a novel anterior stromal micropuncture device (termed a "plexitome") for use in the optical axis of the cornea.
We performed an IRB-approved clinical pilot study on 45 patients with diverse corneal pathologies to determine the safety of the plexitome device and examined corneal healing responses clinically for a minimum of 30 days after treatment. Follow on efficacy data was collected for treated patients with RCE. Micropuncture treatment was performed either through loose epithelial tissue or after debridement using a cotton tip at the slit lamp. After "imprinting," patients were treated with topical medications including antibiotics, hypertonic saline/ointment, bandage contact lenses, and/or patching according to the treating physician's routine care for the condition.
Micropuncture using the "plexitome" device did not create visible scars in the corneal stroma of the 45 patients treated and followed for at least 30 days. Photographic evidence of imprinting was seen at in 1 patient at 30 days. There were no significant adverse events associated with treatment.
Micropuncture of the cornea using the "plexitome" device does not create optically evident anterior stromal scarring after treatment. Micropuncture using the device may be an effective way of treating RCE and other corneal manifestations of EBMD in the optical axis, which is not currently possible using standard anterior stromal puncture methods.
前基质穿刺是一种在裂隙灯下治疗复发性角膜糜烂（RCE）的廉价且广泛应用的技术，RCE是角膜擦伤、外伤及上皮基底膜营养不良（EBMD）的常见后遗症。本研究的目的是确定一种新型前基质微穿刺装置（称为“plexitome”）用于角膜视轴的安全性。
我们对45例患有不同角膜病变的患者进行了一项经机构审查委员会批准的临床试点研究，以确定plexitome装置的安全性，并在治疗后至少30天临床检查角膜愈合反应。收集了接受治疗的RCE患者的后续疗效数据。微穿刺治疗在裂隙灯下通过疏松上皮组织进行，或在使用棉棒清创后进行。“印记”后，根据治疗医师对病情的常规护理，给予患者局部用药，包括抗生素、高渗盐水/眼膏、绷带式隐形眼镜和/或眼罩。
在接受治疗并随访至少30天的45例患者中，使用“plexitome”装置进行微穿刺未在角膜基质中形成可见瘢痕。1例患者在30天时可见印记的照片证据。治疗未出现显著不良事件。
使用“plexitome”装置对角膜进行微穿刺治疗后不会产生光学上明显的前基质瘢痕。使用该装置进行微穿刺可能是治疗视轴上RCE及EBMD其他角膜表现的有效方法，而这是目前标准前基质穿刺方法无法做到的。
