RU2306928C1 - Method for stimulating eye cornea recovery - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves administering palm-oil CAROTINO phonophoresis in eye-baths mode. The phonophoresis is applied to eye region in continuous generation mode at frequency of 880 Hz, insonation intensity of 0.2-0.4 W/cm² daily or every other day during 5 min. The total treatment course is 10-15 procedures long.

EFFECT: enhanced effectiveness of epithelialization and inflammatory infiltrate absorption; prevented degenerative processes occurrence in cornea.

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Description

The invention relates to medicine, namely to ophthalmology, and can be used for the treatment of herpetic keratitis with ulceration of the corneal epithelium, burn eye disease, dry eye syndrome.

It is proved that the violation of the antioxidant defense system of the body plays a role in the pathogenesis of many eye diseases, including infectious and metabolic pathology of the cornea, corneal injury.

There are ways to treat corneal lesions with various antioxidant drugs: vitamins A, C, E; taufon, emoxipin, histochrome, lipin, carnosine, zinc, selenium and others (Pankov O.P. Use of antioxidants in the treatment of eye diseases. - M., 2000; Maychuk Yu.F. Corneal ulcer. - Newspaper "Oculist", 1999, No. 4; Maychuk Yu.F. et al. Effectiveness of the use of carnosine eye drops in the treatment of diseases and excimer laser surgery of the cornea. // Ophthalm. Journal. - 2000. - No. 4. - S.21-24).

The disadvantages of these methods are:

- the insignificance of the antioxidant effect of individual drugs listed;

- the inability to regulate the necessary concentration of the drug in the tissues of the eye, trauma and pain with the injection of these drugs;

- the inability to create a sufficient pharmacotherapeutic concentration of the drug in the tissues of the eye for a short period of time with instillation and oral methods of administration.

The closest analogue prototype of drugs for local treatment of corneal dystrophic processes: herpetic keratitis with ulceration of the corneal epithelium, burn eye disease, dry eye syndrome is phonophoresis of a 30% oil solution of tocopherol acetate (vitamin E) (Sosin I.N., Buyavy A. G. Physical therapy of eye diseases. - Simferopol, Tavria. - 1998, pp. 71-72, 145; Maychuk Yu.F., Rykun VS. Antioxidants, proteinase inhibitors and regeneration stimulants in the treatment of herpetic lesions of the cornea (copy of the report on Research) .- Chelyabinsk, 1988; Satterfield D. et al. Effect of Vitamin E on the Production of Collagen, DNA, and Fibronectin in In Vitro Keratocytes. // GRM, 1989, No. 3, 283).

The disadvantage of this method is:

- a long period of healing of the cornea (long duration of epithelization and resorption of inflammatory infiltrate), due to the lack of tocotrienols, carotenoids, coenzyme Q10 (Mashkovsky M.D. Medicines (a manual for doctors) .- T.2, edition 13th (new). - Kharkov, 1998, p. 95-96).

The objective of the invention is to propose a method of stimulating the regeneration of the cornea of the eye.

The technical result is to improve the quality of rehabilitation of patients with pathology of the cornea of a dystrophic nature: herpetic keratitis with ulceration of the corneal epithelium, burn disease, dry eye syndrome.

The technical result is achieved by the fact that patients with pathology of the cornea of a dystrophic nature are prescribed a bath phonophoresis of palm oil “CAROTINO” on the eye area. In this case, a continuous generation mode is used, the frequency is 880 Hz, the intensity of scoring is 0.2-0.4 W / sq.cm, daily or every other day, the duration of the procedure is 5 minutes. The course of treatment is 10-15 procedures.

Palm oil “CAROTINO” is a powerful antioxidant - an antioxidant involved in cell proliferation, in tissue respiration and in other important processes of cellular metabolism in the tissues of the eye, because contains tocotrienols, which are 40-60 times higher than the antioxidant properties of tocopherols (Prospectus "Tocotrienols", p.12).

The advantages of the proposed method:

- reduction of the start time of epithelization, complete epithelization, and resorption of inflammatory infiltrate due to the use of palm oil “CAROTINO”, which is an antioxidant containing tocotrienols and coenzyme Q10 (Prospectus “Tokotrienols”, p.12);

- the ability to prevent degenerative processes due to the high concentration of carotene and carotenoids in palm oil "CAROTINO" (Prospect "Tokotrienol", p.5; Prospect "CAROTINO" - red oil from palm fruits - an invaluable gift of nature "- M., 2000, p .50-51).

The therapeutic effect was evaluated in 59 patients:

- 20 people with epithelial herpetic keratitis with an expression of corneal stroma;

- 19 people with burn eye disease, stage of trophic disorders;

- 12 people with dry eye syndrome (CVD) with clinical signs of epithelialopathy that arose after an adenovirus infection of the eye (7 people), on the basis of diabetes mellitus (3 people), demodectic blepharoconjunctivitis (2 people).

The results of treatment of 39 people with tocopherol (vitamin E) were considered as a comparison. Of these, 15 people with herpetic epithelial keratitis with ulceration; 10 people - burn disease, stage of trophic disorders; 14 people with dry eye syndrome of similar severity and origin. A comparative analysis of the treatment results is presented in table 1.

The groups were comparable in nosological structure and severity of the pathological process.

The results of the observation showed that the timing of the appearance of the initial signs of epithelization in 17 of 20 patients when using palm oil ranged from 2 to 5 days, the timing of complete epithelization - from 10 to 15 days. When using tocopherol acetate, the signs of initial epithelization occurred later, the delay in the completion of epithelization compared to the group receiving palm oil for several types of the studied pathology ranged from 3 to 6 days, on average 4, 6 days.

Visual acuity in patients receiving palm oil increased from 0.21 on the first day of observation to 0.49 after the end of the procedures. At the same time, 10 out of 51 obtained high visual acuity of 0.6-0.8. In the comparison group, the increase in visual acuity was not so significant - from 0.24 to 0.33, high visual acuity of 0.6-0.8 was obtained only in 5 out of 39 people.

Example 1

Patient S., 47 years old, turned to the consultative and diagnostic department of the ISTC “Eye Microsurgery” in Khabarovsk with a clinical diagnosis: post-burn clouding of the cornea, epithelial dystrophy of the right eye. From the anamnesis: after discharge from the eye hospital, where she was treated for a chemical burn of the cornea of the 2nd degree of severity, lacrimation, photophobia are constantly worried, the eye remains red. For 3 months, in alternating courses, I installed a 4% taufon solution, root root, balarpan in the eye, and received magnetophoresis of a 4% taufon solution. However, the above treatment was ineffective. At the time of contacting the Eye Microsurgery IRTC, phonophoresis of tocopherol acetate was prescribed to stimulate the regeneration of the cornea, which led to the relief of the corneal syndrome and corneal epithelization. However, 3 weeks after the end of treatment, the patient again contacted the IRTC "Eye Microsurgery" with the above complaints. Biomicroscopic examination determined the roughness and defects of the corneal epithelial layer. It was decided to conduct phonophoresis of palm oil. After 7 procedures, corneal epithelization was completed, the cornea acquired shine, its transparency increased. Control examinations carried out 2, 4, 6 months after treatment showed stable reliable results.

Example 2

Patient N., 29 years old, turned to the consultative and diagnostic department of MNTK “Eye Microsurgery” with complaints of discomfort, dry eyes, periodically occurring redness and serous discharge in the form of threads. When examining the corneal epithelium, it is dull, sometimes twisted in the form of filaments, there are microdefects, violations of the structural and functional organization of the precorneal lacrimal film are determined. From the anamnesis: during the year, twice received treatment from an ophthalmologist at the place of residence for adenoviral conjunctivitis. After the studies, the diagnosis was made: symptomatic syndrome of “dry” eyes (CVS). Appointed phonophoresis of palm oil. After 10 procedures, the eye condition improved significantly: the microdefects of the epithelium disappeared and the integrity of the epithelial layer was restored, the transparency of the cornea increased, the condition of the corneal lacrimal film normalized, and the eye injection disappeared. The results of treatment are stably maintained at a 4-month follow-up period.

Example 3

Patient S., 44, was undergoing treatment in the ophthalmotherapy department of the IRTC “Eye Microsurgery” with a clinical diagnosis: herpetic epithelial keratitis with ulceration of the right eye. Despite the ongoing therapy - antiviral, immunocorrective therapy, instillation of regenerative agents such as cornegel, solcoseryl, balarpan and taufon, after 3 weeks of treatment, an erosive epithelial defect, ulceration and inflammatory infiltration of the superficial corneal stroma and a decrease in visual acuity to 0.2. Appointed in addition to ongoing drug therapy phonophoresis of palm oil. After 12 procedures, complete corneal epithelization occurred, the inflammatory infiltration of the corneal stroma resolved, and visual acuity increased to 0.6. After 4 months, the integrity of the epithelial layer was preserved, in the surface layers of the corneal stroma, a small cloud-like clouding was detected, visual acuity increased to 0.7. After 1 year, the result of treatment remains stable.

Table 1 Survey groups No. (people) Recovery Criteria Treatment effectiveness start of epithelization (days) complete epithelization (days) resorption infiltrate (days) recovery (people) improvement (people) no effect (people) Herpetich. epithelium. keratitis BUT twenty 3,1 12.9 14.1 17 3 - AT fifteen 4.2 16,4 18.7 eleven 2 2 Burn eye disease BUT 19 4.1 14.1 16,0 fifteen 3 one B 10 5,0 18.2 21,4 7 2 one Dry eye syndrome with signs of epithelialopathy BUT 12 3,5 13.9 15.7 7 3 2 AT fourteen 5,4 17.5 19.7 6 four four Survey groups: A - patients receiving phonophoresis of palm oil; B - patients receiving phonophoresis of a 30% oil solution of tocopherol acetate.

Claims (1)

A method of stimulating the regeneration of the cornea of the eye, including phonophoresis of an antioxidant, characterized in that palm oil “CAROTINO” is used as an antioxidant by bath phonophoresis in the eye area with a continuous generation mode, frequency 880 Hz, sound intensity 0.2-0.4 W / sq .cm, daily or every other day, lasting 5 minutes, course from 10 to 15 procedures.