Corneal reepithelialization rates following application of bandage contact lenses and eyelid tarsorrhaphy

Purpose:

Our previous work demonstrated that wound healing (reepithelialization,stromal remodeling and scar formation) in the White Leghornchicken cornea is similar to that observed in humans, makingthe chicken a viable animal model for corneal wound healinginvestigations. Additionally, using this animal model we haveshown patching techniques (a traditional treatment method forcorneal epithelial abrasions) to slow reepithelialization comparedto untreated controls (p<0.004). This study objectively quantifiesreepithelialization times and corneal epithelial cell crawlingrates on wounded corneas treated with either a bandage contactlens (BCL) or an eyelid tarsorraphy (TAR).

Methods:

Eighteenadult female White Leghorn chickens were randomly assigned toone of three treatment groups: untreated control, BCL and TAR.The right corneas of each subject had a 5 mm diameter zone debridedcentrally using a Gills’ blade. Following debridementthe appropriate treatment was applied and the subjects werefollowed by fluorescein photography every 4 hours until reepithelializationwas achieved. Using a computerized image analysis system, epithelialdefect areas were quantified at each time point and appropriatestatistical analysis performed.

Results:

The epithelial defecthealing times in both the TAR (36hrs) and BCL (36hrs) treatmentgroups were significantly shorter than controls (44hrs) (p<0.0001for both). Additionally, the corneal epithelial cell crawlingrate in both the TAR and BCL treatment groups was significantlyfaster than controls at 125% of the control rate (p<0.0025for both).

Conclusions:

Bandage contact lens and eye lid tarsorraphyimproved healing times for corneal epithelial defects comparedto controls and the traditionally used pressure patch. Furthermore,the use of a bandage contact lens to treat corneal epithelialdefects allows the subject to continue to use the injured eyeduring healing, an advantage not present in any of the othertreatments tested.