Treatment of corneal defects with delayed re-epithelization with a medical device/drug delivery system for epidermal growth factor.

Background:   Human recombinant epidermal growth factor has been shown to be effective in corneal healing when applied topically. The purpose of this preliminary study was to observe whether re-epithelization occurred in patients with non-healing corneal defects treated with a bandage contact lenses impregnated with epidermal growth factor.

Design:   Prospective non-comparative interventional case series study. Epidermal growth factor-impregnated bandage contact lenses (created through passive transfer of epidermal growth factor into hydrogel contact lenses of high water content) were used to passively release epidermal growth factor to the corneal surface of the damaged eye.

Participants:   Nine clinical patients who presented for tertiary care at the University of British Columbia Eye Care Centre at Vancouver General Hospital.

Methods:   All patients had clinically significant delayed corneal re-epithelization that had not healed despite standard treatments including conventional bandage contact lenses and topical medications. Causes of delayed re-epithelization varied from corneal injuries (e.g. alkali burns, recurrent corneal erosions) to recent corneal surgery (photorefractive keratectomy, phototherapeutic keratectomy, penetrating keratoplasty).

Main Outcome Measures:   Closure of wounds.

Results:   Re-epithelialization was seen in the corneas of seven of the nine patients within 8 days after insertion of the epidermal growth factor-treated bandage contact lens into the damaged eye. The drug delivery system appeared to be most effective in non-inflamed corneas.

Conclusions:   Preliminary results indicate that bandage contact lenses impregnated with epidermal growth factor may be helpful in promoting re-epithelization in corneas with delayed healing. Efficacy appears to be reduced for vascularized and significantly inflamed corneas.