Treatment of Delayed Corneal Re-Epithelization Using a Combined Medical Device/Drug Delivery System for hEGF

Abstract

Purpose: : The purpose of this study was to assess the efficacy of human recombinant epidermal growth factor (hEGF) impregnated bandage contact lenses in the treatment of delayed corneal re-epithelization.

Methods: : A medical device/drug delivery system comprising a contact lens and hEGF were applied to non-healing corneas of 11 clinic patients who presented with delayed corneal re-epithelization. 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). The medical device was created by passively transferring hEGF into hydrogel contact lenses of high water content. hEGF is passively released down a concentration gradient from the lens to the corneal surface as the lens is worn. In addition, the lens acts as a shield for the leading edge of the corneal epithelium.

Results: : Seven of the 11 corneas re-epithelialized within a period of approximately 1 week after using this system. This medical device/drug delivery system appeared to be most effective in non-inflamed corneas. Healing was most rapid for epithelial defects that were neurotrophic in nature and after PRK.

Conclusions: : This medical device/drug delivery system (RapidHeal) appears to be helpful in promoting re-epithelization in corneas with delayed healing. Efficacy was reduced for vascularized and significantly inflamed corneas. Patient factors that may be important to efficacy of treatment and to prognosis for healing with RapidHeal bandage contact lenses will be discussed.

Keywords: cornea: epithelium • wound healing • growth factors/growth factor receptors