Lecithin-bound superoxide dismutase in the treatment of noninfectious corneal ulcers.
OBJECTIVE
To evaluate the effects of a lipophilic analog of superoxide dismutase in the treatment of persistent epithelial defects of the cornea.


METHODS
Interventional case series.


METHODS
Nineteen eyes of 19 patients with noninfectious corneal ulcers were enrolled. Patient profiles consisted of seven cases with Mooren-type peripheral ulcers, three cases with chemical or thermal burns, two cases with vernal keratoconjunctivitis, four cases with cicatricial keratoconjunctivitis, and three cases with sterile ulcers after corneal surgery. Patients consisted of 11 men and 8 women, with a mean age of 51.5 +/- 17.9 years (range, 14-77). Only patients who did not respond to conventional therapy were recruited for the study. Lecithinated superoxide dismutase was applied for 2 weeks, and sketches and/or fluorescein slit micrographs were recorded before and at the end of the study. The main outcome measure was decrease in ulcer size.


RESULTS
As a group, the average ulcer size relative to the entire cornea decreased from 18.2 +/- 15.1% to 10.0 +/- 15.0% after 2 weeks (P <.05). A dramatic effect (>90% decrease in ulcer size) was observed in eight cases (100% in six cases), whereas no apparent change was found (<30% decrease in ulcer size) in five cases. The presence of polymorphonucleocytes within the ulcerated tissue was confirmed by brush cytology.


CONCLUSIONS
Lecinthinated superoxide dismutase was effective in decreasing persistent epithelial defect size in a subset of patients with sterile corneal ulcers refractive to conventional therapy. A large-scale clinical investigation is merited.
Shimmura
Shigeto
S
Department of Ophthalmology, Tokyo Dental College, Japan. shimmura@tdc.ac.jp
Igarashi
Rie
R
Yaguchi
Hiromoto
H
Ohashi
Yoshie
Y
Shimazaki
Jun
J
Tsubota
Kazuo
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000473:pathology; D004341:Drug Evaluation; D019573:Epithelium, Corneal / Q000187:drug effects / Q000473:pathology; D005260:Female; D015590:Fluorophotometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010713:Phosphatidylcholines / Q000627:therapeutic use*; D010865:Pilot Projects; D013482:Superoxide Dismutase / Q000627:therapeutic use*
D009883:Ophthalmic Solutions; D010713:Phosphatidylcholines; D013482:Superoxide Dismutase; C434045:lecithinized superoxide dismutase