Topical fibronectin ophthalmic solution in the treatment of persistent defects of the corneal epithelium

J. F. Gordon, P. Johnson, D. C. Musch, P. A. Asbell, Michael W Belin, M. J. Besson, Z. L. Brister, T. E. Burris, J. C. Casebeer, J. W. Cowden, R. M. Davis, V. P. De Luise, D. E. Denlinger, P. C. Donshik, D. D. Dulaney, D. S. Durrie, R. A. Eiferman, R. J. Epstein, T. D. Fladen

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Abstract

PURPOSE: We sought to evaluate the efficacy of topical fibronectin ophthalmic solution, containing 3.5 mg/ml of human fibronectin, in the treatment of persistent epithelial defects of the cornea. METHODS: In a double-masked, randomized clinical trial, patients with a persistent, corneal epithelial defect of at least 14 days in duration, and at least 2 mm in width along the larger axis, were sought from the practices of 38 clinical investigators. After a 14-day washout period, 65 patients were randomly assigned to one of three treatment groups. One group (n = 20) received fibronectin drops; the second (n = 23) received drops of the vehicle from the fibronectin solution; and the third (n = 22) received a placebo. RESULTS: After 21 days of treatment, there was no difference in percentage reduction of the corneal epithelial defect size; the average percentage of reduction of defect area ranged from 46.5% to 54.3%. Fibronectin treatment showed a beneficial effect for patients with larger baseline defects (10 mm2 or greater in area); however, no such effect was observed among patients with smaller defects. Defect duration before treatment had a significant effect on outcome (P = .007); defects of longer duration were less likely to decrease in size over the course of the study. CONCLUSIONS: All three treatment groups showed similar reductions in defect size; therefore, this study provides no support for the efficacy of fibronectin treatment of persistent, corneal epithelial defects. Defect duration showed a negative association with reduction in defect size. Because strict control of topical applications during the washout and treatment periods resulted in beneficial responses, physicians should carefully consider the topical medications used by patients who have persistent, corneal epithelial defects.

Original languageEnglish (US)
Pages (from-to)281-287
Number of pages7
JournalAmerican Journal of Ophthalmology
Volume119
Issue number3
StatePublished - 1995
Externally publishedYes

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Corneal Epithelium
Ophthalmic Solutions
Fibronectins
Therapeutics
Cornea
Randomized Controlled Trials
Placebos
Research Personnel
Physicians

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Gordon, J. F., Johnson, P., Musch, D. C., Asbell, P. A., Belin, M. W., Besson, M. J., ... Fladen, T. D. (1995). Topical fibronectin ophthalmic solution in the treatment of persistent defects of the corneal epithelium. American Journal of Ophthalmology, 119(3), 281-287.

Topical fibronectin ophthalmic solution in the treatment of persistent defects of the corneal epithelium. / Gordon, J. F.; Johnson, P.; Musch, D. C.; Asbell, P. A.; Belin, Michael W; Besson, M. J.; Brister, Z. L.; Burris, T. E.; Casebeer, J. C.; Cowden, J. W.; Davis, R. M.; De Luise, V. P.; Denlinger, D. E.; Donshik, P. C.; Dulaney, D. D.; Durrie, D. S.; Eiferman, R. A.; Epstein, R. J.; Fladen, T. D.

In: American Journal of Ophthalmology, Vol. 119, No. 3, 1995, p. 281-287.

Research output: Contribution to journalArticle

Gordon, JF, Johnson, P, Musch, DC, Asbell, PA, Belin, MW, Besson, MJ, Brister, ZL, Burris, TE, Casebeer, JC, Cowden, JW, Davis, RM, De Luise, VP, Denlinger, DE, Donshik, PC, Dulaney, DD, Durrie, DS, Eiferman, RA, Epstein, RJ & Fladen, TD 1995, 'Topical fibronectin ophthalmic solution in the treatment of persistent defects of the corneal epithelium', American Journal of Ophthalmology, vol. 119, no. 3, pp. 281-287.
Gordon, J. F. ; Johnson, P. ; Musch, D. C. ; Asbell, P. A. ; Belin, Michael W ; Besson, M. J. ; Brister, Z. L. ; Burris, T. E. ; Casebeer, J. C. ; Cowden, J. W. ; Davis, R. M. ; De Luise, V. P. ; Denlinger, D. E. ; Donshik, P. C. ; Dulaney, D. D. ; Durrie, D. S. ; Eiferman, R. A. ; Epstein, R. J. ; Fladen, T. D. / Topical fibronectin ophthalmic solution in the treatment of persistent defects of the corneal epithelium. In: American Journal of Ophthalmology. 1995 ; Vol. 119, No. 3. pp. 281-287.
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abstract = "PURPOSE: We sought to evaluate the efficacy of topical fibronectin ophthalmic solution, containing 3.5 mg/ml of human fibronectin, in the treatment of persistent epithelial defects of the cornea. METHODS: In a double-masked, randomized clinical trial, patients with a persistent, corneal epithelial defect of at least 14 days in duration, and at least 2 mm in width along the larger axis, were sought from the practices of 38 clinical investigators. After a 14-day washout period, 65 patients were randomly assigned to one of three treatment groups. One group (n = 20) received fibronectin drops; the second (n = 23) received drops of the vehicle from the fibronectin solution; and the third (n = 22) received a placebo. RESULTS: After 21 days of treatment, there was no difference in percentage reduction of the corneal epithelial defect size; the average percentage of reduction of defect area ranged from 46.5{\%} to 54.3{\%}. Fibronectin treatment showed a beneficial effect for patients with larger baseline defects (10 mm2 or greater in area); however, no such effect was observed among patients with smaller defects. Defect duration before treatment had a significant effect on outcome (P = .007); defects of longer duration were less likely to decrease in size over the course of the study. CONCLUSIONS: All three treatment groups showed similar reductions in defect size; therefore, this study provides no support for the efficacy of fibronectin treatment of persistent, corneal epithelial defects. Defect duration showed a negative association with reduction in defect size. Because strict control of topical applications during the washout and treatment periods resulted in beneficial responses, physicians should carefully consider the topical medications used by patients who have persistent, corneal epithelial defects.",
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AU - Gordon, J. F.

AU - Johnson, P.

AU - Musch, D. C.

AU - Asbell, P. A.

AU - Belin, Michael W

AU - Besson, M. J.

AU - Brister, Z. L.

AU - Burris, T. E.

AU - Casebeer, J. C.

AU - Cowden, J. W.

AU - Davis, R. M.

AU - De Luise, V. P.

AU - Denlinger, D. E.

AU - Donshik, P. C.

AU - Dulaney, D. D.

AU - Durrie, D. S.

AU - Eiferman, R. A.

AU - Epstein, R. J.

AU - Fladen, T. D.

PY - 1995

Y1 - 1995

N2 - PURPOSE: We sought to evaluate the efficacy of topical fibronectin ophthalmic solution, containing 3.5 mg/ml of human fibronectin, in the treatment of persistent epithelial defects of the cornea. METHODS: In a double-masked, randomized clinical trial, patients with a persistent, corneal epithelial defect of at least 14 days in duration, and at least 2 mm in width along the larger axis, were sought from the practices of 38 clinical investigators. After a 14-day washout period, 65 patients were randomly assigned to one of three treatment groups. One group (n = 20) received fibronectin drops; the second (n = 23) received drops of the vehicle from the fibronectin solution; and the third (n = 22) received a placebo. RESULTS: After 21 days of treatment, there was no difference in percentage reduction of the corneal epithelial defect size; the average percentage of reduction of defect area ranged from 46.5% to 54.3%. Fibronectin treatment showed a beneficial effect for patients with larger baseline defects (10 mm2 or greater in area); however, no such effect was observed among patients with smaller defects. Defect duration before treatment had a significant effect on outcome (P = .007); defects of longer duration were less likely to decrease in size over the course of the study. CONCLUSIONS: All three treatment groups showed similar reductions in defect size; therefore, this study provides no support for the efficacy of fibronectin treatment of persistent, corneal epithelial defects. Defect duration showed a negative association with reduction in defect size. Because strict control of topical applications during the washout and treatment periods resulted in beneficial responses, physicians should carefully consider the topical medications used by patients who have persistent, corneal epithelial defects.

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