Aplicação da membrana de biocelulose embebida em ciprofloxacina na ceratoplastia lamelar
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Data
2019-08-16
Autores
Pedroza, Thiago de Melo
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Universidade Estadual Paulista (Unesp)
Resumo
Avaliaram-se os sinais clínicos oculares da ceratoplastia lamelar, utilizando-se a membrana de biocelulose (MB) embebida em ciprofloxacina em duas espessuras, no tratamento de úlceras de córneas profundas e/ou perfuradas, em cães e gatos, com ceratite ulcerativa com sequestro de córnea. A celulose possui aplicações importantes na engenharia de tecidos, como a reparação e cicatrização de feridas. Os principais exemplos são as aplicações que incluem engenharia de vasos sanguíneos, tecido neural, osso, cartilagem, fígado e tecido adiposo, reconstrução da uretra e dura-máter, reparação de tecido conjuntivo e defeitos cardíacos congênitos, construção de barreiras protetoras e aplicações oftalmológicas, principalmente construção de contato lentes. Os animais foram divididos igualmente em dois grupos, onde um (G-HE) recebeu a membrana hidratada espessa e outro recebeu (G-HD) hidratada delgada. Previamente ao emprego da MB, as mesmas foram recortadas em discos de 3-4mm e adaptadas ao leito das úlceras, utilizando-se sutura não perfurante total, em pontos simples isolados. Instituiram-se, por terapia pós-operatória, colírios à base de ciprofloxacina, diclofenaco sódico, atropina, lubrificante ocular e colar do tipo elizabetano. As causas das úlceras foram, também, tratadas. Avaliaram-se os sinais clínicos oculares no pós-operatório aos 3, 7, 15, 30 e 60 dias. A MB e os pontos de suturas foram removidos ao trigésimo dia. Sinais clínicos como blefarospasmo, presença de secreção ocular, hiperemia conjuntival e vascularização corneal estiveram presentes em ambos os grupos até o 15º dia de pós-operatório reduzindo, gradualmente, ao longo do tempo. Não foram observados sinais de rejeição da membrana nos períodos avaliados. Portanto a MB favoreceu a epitelização corneal, sendo uma alternativa terapêutica para lesões corneais infectadas ou não. No entanto, a MB induz a uma maior angiogênese nos casos de perfuração, com consequente ceratite pigmentar intra e perilesional.
Clinical ocular signs of lamellar keratoplasty were evaluated using a two-thickness ciprofloxacin-embedded biocellulose membrane (MB) in the treatment of deep and / or perforated corneal ulcers in dogs and cats with sequestered ulcerative keratitis. of cornea. Cellulose has important applications in tissue engineering, such as wound repair and healing. Top examples are applications that include blood vessel engineering, neural tissue, bone, cartilage, liver and adipose tissue, urethral and dura mater reconstruction, connective tissue repair and congenital heart defects, protective barrier construction and ophthalmic applications, mainly construction of contact lenses. The animals were divided equally into two groups, where one (G-HE) received the thick hydrated membrane and the other received thin hydrated (G-HD). Prior to the use of MB, they were cut in 3-4mm discs and adapted to the ulcer bed, using total nonperforating suture, in isolated single stitches. Postoperative therapy was followed by eye drops based on ciprofloxacin, diclofenac sodium, atropine, eye lubricant and Elizabethan collar. The causes of ulcers were also treated. Postoperative ocular clinical signs were evaluated at 3, 7, 15, 30 and 60 days. MB and suture stitches were removed on day 30. Clinical signs such as blepharospasm, presence of ocular discharge, conjunctival hyperemia, and corneal vascularization were present in both groups until the 15th postoperative day, gradually decreasing over time. No signs of membrane rejection were observed in the evaluated periods. Therefore, MB favored corneal epithelialization, being a therapeutic alternative for infected or uninfected corneal lesions. However, MB induces greater angiogenesis in perforation cases, with consequent intra and perilesional pigmentary keratitis
Clinical ocular signs of lamellar keratoplasty were evaluated using a two-thickness ciprofloxacin-embedded biocellulose membrane (MB) in the treatment of deep and / or perforated corneal ulcers in dogs and cats with sequestered ulcerative keratitis. of cornea. Cellulose has important applications in tissue engineering, such as wound repair and healing. Top examples are applications that include blood vessel engineering, neural tissue, bone, cartilage, liver and adipose tissue, urethral and dura mater reconstruction, connective tissue repair and congenital heart defects, protective barrier construction and ophthalmic applications, mainly construction of contact lenses. The animals were divided equally into two groups, where one (G-HE) received the thick hydrated membrane and the other received thin hydrated (G-HD). Prior to the use of MB, they were cut in 3-4mm discs and adapted to the ulcer bed, using total nonperforating suture, in isolated single stitches. Postoperative therapy was followed by eye drops based on ciprofloxacin, diclofenac sodium, atropine, eye lubricant and Elizabethan collar. The causes of ulcers were also treated. Postoperative ocular clinical signs were evaluated at 3, 7, 15, 30 and 60 days. MB and suture stitches were removed on day 30. Clinical signs such as blepharospasm, presence of ocular discharge, conjunctival hyperemia, and corneal vascularization were present in both groups until the 15th postoperative day, gradually decreasing over time. No signs of membrane rejection were observed in the evaluated periods. Therefore, MB favored corneal epithelialization, being a therapeutic alternative for infected or uninfected corneal lesions. However, MB induces greater angiogenesis in perforation cases, with consequent intra and perilesional pigmentary keratitis
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Palavras-chave
Membranas (Biologia), Celulose, Córnea, Cães, Gatos, Membranes, Cellulose, Cornea, Dogs, Cats