DSpace Collection:
https://hdl.handle.net/10171/18913
2024-03-28T15:01:07ZTopical Tacrolimus for Corneal Subepithelial Infiltrates Secondary to Adenoviral Keratoconjunctivitis
https://hdl.handle.net/10171/69076
Title: Topical Tacrolimus for Corneal Subepithelial Infiltrates Secondary to Adenoviral Keratoconjunctivitis
Abstract: Purpose:
The objective of this study was to determine the efficacy and safety of topical tacrolimus compounded in the Pharmacy Service for the treatment of subepithelial corneal infiltrates (SEIs) secondary to adenoviral keratoconjunctivitis.
Methods:
This retrospective study included patients who had been dispensed topical tacrolimus for the treatment of SEIs during the previous year. Patients were treated with tacrolimus 0.03% eye drops twice daily or tacrolimus 0.02% ointment once daily. The following data were recorded: length of treatment, visual acuity before and after treatment, intraocular pressure before, during, and at the end of treatment, previous treatments, and the presence of SEIs after treatment. The subjective symptoms of the patients were also assessed.
Results:
Fifty-five patients (85 eyes) were included, 54.5% with bilateral involvement. A total of 31 (36.5%) eyes were treated with tacrolimus ointment and 54 eyes (63.5%) with tacrolimus eye drops. The median length of treatment was 185 days (p25–75: 93.5–426), and the mean follow-up duration was 363 days (p25–75: 148–540). In 62.35% of the eyes, the SEIs were reduced in number and size, and in 31.76%, they were eliminated. The patients had better visual acuity after treatment with highly statistically significant differences. Tolerance was good overall, being better in the eye drops group.
Conclusions:
Topical tacrolimus, compounded in the pharmacy, seems to be an effective and safe alternative for the treatment of SEIs secondary to adenovirus keratoconjunctivitis.2017-01-01T00:00:00ZPlasma rich in growth factors membrane as coadjuvant treatment in the surgery of ocular surface disorders
https://hdl.handle.net/10171/69074
Title: Plasma rich in growth factors membrane as coadjuvant treatment in the surgery of ocular surface disorders
Abstract: To evaluate the safety and efficacy of the surgical use of plasma rich in growth factors fibrin membrane (mPRGF) in different ocular
surface pathologies.
Fifteen patients with different corneal and conjunctival diseases were included in the study. Patients were grouped according to the
use of mPRGF as graft (corneal and/or conjunctival) or dressing; they were also grouped according to the surgical subgroup of
intervention (persistent corneal ulcer [PCU], keratoplasty, superficial keratectomy, corneal perforation, and pterygium). Best
corrected visual acuity, intraocular pressure (IOP), inflammation control time (ICT), mPRGF AT (PRGF membrane absorption time),
and the healing time of the epithelial defect (HTED) were evaluated throughout the clinical follow-up time. Safety assessment was also
performed reporting all adverse events.
mPRGF showed a total closure of the defect in 13 of 15 patients (86.7%) and a partial closure in 2 patients (13.3%). The mean
follow-up time was 11.1±4.2 (4.8–22.8) months, the mean ICT was 2.5±1.1 (1.0–4.0) months, the mean mPRGF AT was 12.4±2.0
(10.0–16.0) days, and for the global HTED the mean was 2.9±1.2 (1–4.8) months. Results showed an improvement in BCVA in all
patients, with an overall improvement of 2.9 in Vision Lines. The BCVA significantly improved (P<.05) in the groups of corneal graft
and dressing. In the PCU subgroup (6 patients), the healing time of epithelial defect was significantly reduced (P<.05) in patients
treated only with the mPRGF in comparison to those which mPRGF therapy was associated to the amniotic membrane. The IOP
remained stable (P>.05) throughout the clinical follow-up time. No adverse events were reported after mPRGF use.
The mPRGF is effective and safe as coadjuvant treatment in surgeries related with ocular surface disorders, being an alternative to
the use of amniotic membrane. The mPRGF accelerates tissue regeneration after ocular surface surgery thus minimizing
inflammation and fibrosis.2018-01-01T00:00:00ZMini Cleanroom for the Manufacture of Advanced Therapy Medicinal Products (ATMP): Bioengineered Corneal Epithelium
https://hdl.handle.net/10171/69073
Title: Mini Cleanroom for the Manufacture of Advanced Therapy Medicinal Products (ATMP): Bioengineered Corneal Epithelium
Abstract: Among several requirements for the manufacture of Advanced Therapy Medicinal
Products (ATMP) are: following the guidelines of a pharmaceutical quality system, complying with
Good Manufacturing Practice (GMP) and access to a cleanroom fulfilling strict environmental
conditions (Class A work area and Class B environment). This makes ATMP expensive. Moreover,
the production of many of these therapeutic products may also be unprofitable, as in most cases
their use is limited to a few patients and to a single batch per manufacturing unit. To reduce costs,
ATMP may be produced in a scaled-down system isolated from the external environment (isolator),
allowing for placement of this facility in a Class D environment, which is much more permissive
and less costly. In this work, we confirm that it is possible to manufacture bioengineered corneal
epithelium inside an isolator while fulfilling all the safety assurance standards at an affordable cost
for patients. This small-scale ultra-clean working environment complies with GMP guidelines and
could be a solution for the high costs associated with conventional cleanroom ATMP production.2021-01-01T00:00:00ZAutologous method for ex vivo expansion of human limbal epithelial progenitor cells based on plasma rich in growth factors technology
https://hdl.handle.net/10171/69072
Title: Autologous method for ex vivo expansion of human limbal epithelial progenitor cells based on plasma rich in growth factors technology
Abstract: Purpose
Develop an autologous culture method for ex vivo expansion of human limbal epithelial progenitor cells (LEPCs) using Plasma Rich in Growth Factors (PRGF) as a growth supplement and as a scaffold for the culture of LEPCs.
Methods
LEPCs were cultivated in different media supplemented with 10% fetal bovine serum (FBS) or 10% PRGF. The outgrowths, total number of cells, colony forming efficiency (CFE), morphology and immunocytochemistry against p63- α and cytokeratins 3 and 12 (CK3-CK12) were analyzed. PRGF was also used to elaborate a fibrin membrane. The effects of the scaffold on the preservation of stemness and the phenotypic characterization of LEPCs were investigated through analysis of CK3-CK12, ABCG-2 and p63.
Results
LEPCs cultivated with PRGF showed a significantly higher growth area than FBS cultures. Moreover, the number of cells were also higher in PRGF than FBS, while displaying a better morphology overall. CFE was found to be also higher in PRGF groups compared to FBS, and the p63-α expression also differed between groups. LEPCs cultivated on PRGF membranes appeared as a confluent monolayer of cells and still retained p63 and ABCG-2 expression, being negative for CK3-CK12.
Conclusions
PRGF can be used in corneal tissue engineering, supplementing the culture media, even in a basal media without any other additives, as well as providing a scaffold for the culture.2017-01-01T00:00:00Z