Fast and sustained healing of resistant corneal ulcers using corneal scrubbing and matrix regenerating therapy

Eur J Ophthalmol. 2021 May;31(3):959-966. doi: 10.1177/1120672120921379. Epub 2020 Apr 28.

Abstract

Aim: The aim of this study was to assess the efficacy and safety of corneal scrubbing associated with matrix regenerating agent on corneal wound healing in patients with persistent corneal ulcers.

Methods: This was a retrospective case study in patients with difficult-to-treat corneal ulcer. Corneal scrubbing was performed with a sterile dry cotton bud to eliminate damaged epithelial cells and corneal deposits, promoting epithelial renewal. Regenerating agent was then administered as one eye drop every 2 days in addition to preservative-free ocular lubricants. A bandage contact lens was applied in case of moderate-to-severe corneal pain. Corneal ulcers were regularly assessed until healing.

Results: In total, 17 patients with a chronic corneal ulcer of various etiologies for several months on average were enrolled. Corneal scrubbing combined with regenerating agent administration led to a rapid corneal ulcer size reduction from 26.4 ± 20.6 mm2 after scrubbing (before regenerating agent) to 7.2 ± 7.1 mm2 at day 5, 3.3 ± 6.0 mm2 at day 10, and 0.9 ± 2.3 mm2 at day 18. Complete corneal ulcer healing was observed in 35.2% of patients within 10 days, in 70.4% within 18 days, and in all patients within 25 days. Corneal ulcer relapse was observed in two (11.8%) patients after 6 weeks and 5 months, respectively; both were successfully treated using the same procedure. The regenerating agent was well tolerated in all patients.

Conclusion: In this study, combined corneal scrubbing and matrix regenerating therapy (with or without bandage contact lens) led to a rapid healing and successful resolution of persisting corneal ulcers, including large and deep corneal ulcers.

Keywords: Corneal scrubbing; corneal ulcer; corneal wound healing; heparan sulfate; matrix regenerating agents.

MeSH terms

  • Cornea
  • Corneal Ulcer* / drug therapy
  • Humans
  • Ophthalmic Solutions
  • Retrospective Studies
  • Wound Healing

Substances

  • Ophthalmic Solutions