Posters

Treatment of corneal descemetocele with topical matrix therapy agent

Poster Details

First Author: Y. Fernandez Barrientos SPAIN

Co Author(s): A. Ramos Suarez   J. Garrido Linares                 

Abstract Details

Purpose:

we report a case of a persistent epithelial defect no response to autologous serum, platelet rich plasma, amniotic membrane transplantation and pedicle conjuntival flap, which presented a corneal descemetocele. The use of regenerative matrix therapy agent(RGTA) was indicated trying to support the growth of the conjunctiva over the descemetocele for the restoration of the ocular surface integrity.

Setting:

Hospital Costa del Sol, Marbella, Spain.

Methods:

Photographs and anterior segment tomography (AS-OCT) before treatment and during the follow up. A 88 years old woman with limbal deficiency ,two surgeries pterygium. A conjunctival intraepithelial neoplasia was diagnosed and treated with MMC 0.02 %. She developed a persistent epithelial defect (DEP) with no respond to treatment with autologous serum, platelet-rich plasma (RPR) and two amniotic membrane transplants. A descematocele was developed. A conjunctival graft was decided. Postoperatively the conjunctiva was retracted in the area of descematocele presenting a large associated inflammatory component and continued to progress. Therapy with a regenerating agent RGTA, carboximetilglucosa polysulfate 0.01% (Cacicol ®) was indicated.

Results:

There was an advancement of the conjunctival flap over the descemetocele. In the AS-OCT examination the increase of corneal thickness and reduced descematocele area was evidenced. At present corneal thickness remained stable, and ocular surface integrity has been restored . The patient is treated with 20% autologous serum, every 8 hours and ophthalmic gel dexpanthenol 5%, every 24 hours.

Conclusions:

the use of tissue regenerating agent (RGTA) or polysulfate carboximetilglucosa 0.01% (Cacicol®) provided support for the growth of conjunctival graft over the thinned area, favoring the action of growth factors PRP despite the large inflammatory component and limbal deficiency.

Financial Disclosure:

None