OCULAR SURFACE, CORNEA AND CONJUNCTIVA
NEW TREATMENTS FOR DRY EYE. STEM CELLS
Although most patients affected by dry eye, do not suffer from a serious condition, we are aware that this pathology is very annoying, follows a chronic pattern, related to other diseases and can even alter vision. Until recently, there were not many alternatives with regard to artificial tears; new treatments have appeared that can help these patients.
The first step is to establish the causes of this disease, a task that is not always easy, for it requires an expert ophthalmologist on these diseases, and so we have created the Dry Eye and Ocular Surface Unit. Once we know the source, we study the most important symptoms and signs so that we can establish the appropriate therapeutic remedy, taking advantage of the new procedures that have recently appeared. It is important to become aware that it is not a question of trying new things, as if they were in a catalog, until we find the most convenient.
Along with the new generation of artificial tears (of different chemical composition), which allow choosing the most appropriate one for every case, other tears without preservatives have appeared; these last being key to an effective therapy. Hematic derivatives as autologous serum have been very effective in moderate and severe cases and their effectiveness can be improved with the association of topical immunosuppressants such as Cyclosporin A, a drug long claimed for and of high utility.
To retain the patient's tear and avoid adding drugs that may cause hypersensitivity or other toxic effects, there are new tear "caps" that are very effective and easy to implement (without surgery).
Perhaps the newest on these remedies are the biological treatments to control the inflammatory and metabolic response in the lacrimal gland and ocular surface, especially stem cell implants. Although these treatments are still in the experimental phase, our ophthalmology department has pioneered and controlled work groups to show the effectiveness and we are getting very encouraging results.
ANALYSIS OF TEARS
Many ocular surface diseases such as dry eye, degenerations and dystrophies, develop with alterations in the tear system. Therefore, the tear analysis may be essential for proper diagnosis and treatment. In our unit we have compiled a set of tests that allow us to analyze tear osmolarity, immunoglobulins in allergic disorders, cytokines in inflammatory processes and impression cytology in degenerative processes and of tumor type, avoiding the need for surgical biopsy in most cases.
LAMELLAR AND ENDOTHELIAL CORNEAL TRANSPLANT
Many cornea-related problems, especially a scar in the eye tissue that prevents a correct vision, shall be treated by transplant of this structure. The results are good but the recovery process is very slow, more than one year in most cases, with the risk of inflammation and immune rejection. To avoid these problems, new techniques have been developed consisting of layered or lamellar transplant, i.e. it will only be transplanted the damaged part of the cornea; the trauma is much smaller, reducing the risk of complications and functional recovery of the patient is faster, by months or even weeks.
The technology is complex but the global leading trading company, named MORIA has chosen our center and equipped us with everything needed to make such surgery possible. The results are "simply" spectacular; we hope to make the greatest possible number of surgeries to solve problems that were previously untreatable or with a very high risk of failure.