Clinical ophthalmology (Auckland, N.Z.) · 2026
Retrospective Evaluation of Successive Biovance ® Decellularized Basement Membrane Tissue Grafts for the Management of Chronic Subclinical and Stage 1 Neurotrophic Keratitis.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ayres Brandon D, Fram Nicole R, Wu Helen K, Feulner Lisa, Desai Neel R
Аннотация
PURPOSE: To evaluate the clinical outcomes of serial placement of an amniotic decellularized basement membrane (DBM) graft (Biovance®) in patients with subclinical or Mackie Stage 1 neurotrophic keratitis (NK). The primary objective was to assess changes in corneal fluorescein staining and functional corneal sensitivity, with tear osmolarity and metalloproteinase-9 (MMP-9) used as adjunctive indicators of ocular surface stability.
METHODS: This retrospective study included eyes with reduced corneal sensitivity (Brill esthesiometry Levels 3-5), epithelial staining, and positive MMP-9, consistent with subclinical or Mackie Stage 1 NK. Each eye underwent serial DBM graft placement guided by clinical response over an average of 7 weeks. Corneal fluorescein staining, Brill esthesiometry, tear osmolarity, and MMP-9 status were assessed at each visit. Follow-up occurred every 1-2 weeks, with treatment advanced upon improvements in corneal staining and stabilizing biomarker trends. Outcomes included clinician-documented resolution of epithelial staining, changes in corneal sensitivity, and normalization of tear osmolarity and MMP-9.
RESULTS: A total of 936 eyes from 488 patients met enrollment criteria. Mean DBM utilization increased with disease severity (Brill 3: 3.70; Brill 4: 3.08; Brill 5: 4.30 grafts). Corneal epithelial resolution occurred in all eyes with complete follow-up. Functional corneal sensitivity improved in 0.7% of Brill 3, 31.6% of Brill 4, and 77.5% of Brill 5 eyes. Among eyes with abnormal baseline osmolarity, 70-82% normalized following treatment. MMP-9 positivity decreased across all severity groups, with 56-66% converting to negative, corresponding with improved ocular surface stability.
CONCLUSION: Serial DBM grafting was associated with improvements in corneal staining, functional corneal sensitivity, ocular surface inflammation, and tear-film homeostasis, supporting its role in early-stage NK management. These findings suggest DBM promotes epithelial and neurosensory recovery through host-matrix interactions within the preserved basement membrane and that early intervention may help mitigate disease progression.
METHODS: This retrospective study included eyes with reduced corneal sensitivity (Brill esthesiometry Levels 3-5), epithelial staining, and positive MMP-9, consistent with subclinical or Mackie Stage 1 NK. Each eye underwent serial DBM graft placement guided by clinical response over an average of 7 weeks. Corneal fluorescein staining, Brill esthesiometry, tear osmolarity, and MMP-9 status were assessed at each visit. Follow-up occurred every 1-2 weeks, with treatment advanced upon improvements in corneal staining and stabilizing biomarker trends. Outcomes included clinician-documented resolution of epithelial staining, changes in corneal sensitivity, and normalization of tear osmolarity and MMP-9.
RESULTS: A total of 936 eyes from 488 patients met enrollment criteria. Mean DBM utilization increased with disease severity (Brill 3: 3.70; Brill 4: 3.08; Brill 5: 4.30 grafts). Corneal epithelial resolution occurred in all eyes with complete follow-up. Functional corneal sensitivity improved in 0.7% of Brill 3, 31.6% of Brill 4, and 77.5% of Brill 5 eyes. Among eyes with abnormal baseline osmolarity, 70-82% normalized following treatment. MMP-9 positivity decreased across all severity groups, with 56-66% converting to negative, corresponding with improved ocular surface stability.
CONCLUSION: Serial DBM grafting was associated with improvements in corneal staining, functional corneal sensitivity, ocular surface inflammation, and tear-film homeostasis, supporting its role in early-stage NK management. These findings suggest DBM promotes epithelial and neurosensory recovery through host-matrix interactions within the preserved basement membrane and that early intervention may help mitigate disease progression.