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FAB method for chronic corneal epithelial defects

A novel approach to treatment of non-healing corneal epithelial defects with self administration of finger prick autologous whole blood (FAB method). Prof. A. Sharma, Moorfields Eye Hospital, Mr. D. Armstrong, Prof. J. E . Moore, Mater Hospital, Belfast

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FAB method for chronic corneal epithelial defects

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  1. A novel approach to treatment of non-healing corneal epithelial defects with self administration of finger prick autologous whole blood (FAB method) Prof. A. Sharma, Moorfields Eye Hospital, Mr. D. Armstrong, Prof. J. E. Moore, Mater Hospital, Belfast The Authors have no financial interest

  2. FAB method for chronic corneal epithelial defects • Autologous serum is used for chronic ulcers and dry eyes (1,2,3). • Four patients with persistent corneal epithelial defects resistant to full conventional medical therapy including steroids and lubricants drops were recruited. • The causation was post chemical trauma ( figure 1a, 1b and 2) and the other three cases secondary to herpetic simplex neurotrophic • ulceration. • Each patient carried out the following technique. A fingertip was wiped with an alcohol steret and self pricked using a standard diabetic lancet (4). The drop of blood is produced as normal and applied to the lower fornix of the affected eye with the lower lid pulled down slightly. The blood was applied four times a day. A different finger can be used each time. FAB was used in conjunction with conventional therapy.

  3. FAB method for chronic corneal epithelial defects • All four patients showed improved corneal epithelial healing within one week. Their comfort was reported to be improved in all cases. • All cases demonstrated complete epithelial healing within two weeks of commencing FAB therapy. • There was a recurrence of epithelial defect in a herpetic patient following a period of initial re- • epithelialisation, this was a case of dense neurotrophia which re-responded positively to increased use of autologous blood. This patient is now maintained on six times per day and has been on FAB for the last 18 months.

  4. FAB method for chronic corneal epithelial defects Figure 1a Complete epithelial loss acutely folowing chemical injury, with limbalischaemia. Figure 1b Appearance of same eye 9 days following intensive medical management. Persistantepithelial defect present

  5. FAB method for chronic corneal epithelial defects Figure 2 Patient featured in Figure 1 Sixweeks following administration of FAB. Epithelial defect remains healed and no staining with fluorescein In this observational study FAB appears to be a safe and effective technique for persistent corneal epithelial defects. In one patient the FAB method was used successfully qds for 18 months. If not used as a long term treatment , it may be a therapeutic trial for justification of autologous serum use. Further studies are required into the effectiveness of FAB and it uses in other conditions such as dry eye.

  6. FAB method for chronic corneal epithelial defects • References • Comparison of autologous serum eye drops with conventional therapy in a randomised controlled crossover trial for ocular surface disease. Noble B A, et al. Br. J. Ophthalmol. (2004) 88, 647-652. • Autologous serum eyedrops for dry eyes and epithelial defects: clinical and in vitro toxicity studies. Poon A C, et al. Br J Ophthalmol (2001) 85, 1188-1197. • Treatment of persistent corneal epithelial defects by autologous serum application. Tsubota K, et al Ophthalmology (1999) 106, 1984-1989. • Simple finger prick fresh blood technique for use on the ocular surface Sharma A, Sharma B A R , Moore J, Nolan M. Cont Lens Anterior Eye. 2011 Feb;34(1):49. Epub 2010 Sep 15.

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