Concomitant Bandage Contact Lens, Oral Nicergoline, and Topical Autologous Serum for Severe Neurotrophic Keratitis
Por:
Polania-Baron, Eduardo J., Graue-Hernandez, Enrique O., Ramirez-Miranda, Arturo, Navas, Alejandro
Publicada:
1 mar 2023
Resumen:
Background:To report the outcomes of using the combination of oral
nicergoline, autologous serum, and contact lens to enhance corneal
epithelization in neurotrophic keratitis and to discuss the clinical
potential of this management.Methods:This was a prospective consecutive
case series study of eight patients treated for neurotrophic keratitis
at the ``Conde de Valenciana'' Institute of Ophthalmology. Oral
nicergoline, autologous serum, and bandage contact lens were initiated
at the same time, immediately after stage 3 diagnosis keratitis was
confirmed clinically, and until corneal epithelialization was achieved
or eminent corneal perforation was seen. In patients where diabetes was
a cause, glycosylate hemoglobin was measured to asses metabolic control.
Corneal esthesiometry and corrected distance visual acuity were assessed
before and after treatment.Results:This study included eight eyes of
eight patients (5 men [62.5%], average age 57 +/- 17.9 years). All
patients completed at least 1 month of follow-up after nicergoline and
contact lens suspension. Of the eight eyes, no one had positive culture
growth and complete epithelial healing was achieved in all cases. Half
of patients had diabetes and had a poor metabolic control. Corneal
sensitivity improved in all eyes almost 2 centimeters in Cochet-Bonnet
esthesiometry (P=0.01). In addition, final visual acuity gains were
obtained (P=0.100).Conclusions:The combination of oral nicergoline,
autologous serum, and bandage contact lens simultaneously could be an
alternative in the management of stage 3 neurotrophic keratitis when
conventional medical treatment has no improvement of corneal
epithelization.
Filiaciones:
Polania-Baron, Eduardo J.:
Inst Oftalmol Conde de Valenciana, Dept Cornea External Dis & Refract Surg, Mexico City, Mexico
Graue-Hernandez, Enrique O.:
Inst Oftalmol Conde de Valenciana, Dept Cornea External Dis & Refract Surg, Mexico City, Mexico
Ramirez-Miranda, Arturo:
Inst Oftalmol Conde de Valenciana, Dept Cornea External Dis & Refract Surg, Mexico City, Mexico
Navas, Alejandro:
Inst Oftalmol Conde de Valenciana, Dept Cornea External Dis & Refract Surg, Mexico City, Mexico
Univ Nacl Autonoma Mexico, Inst Ophthalmol Conde de Valenciana, Chimalpopoca 14,Col Obrera, Mexico City 06800, Mexico
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