Prospects for the use of ion-exchange therapeutic lenses in the treatment of inflammatory and dystrophic corneal diseases

Background. Among patients seeking ophthalmic care in outpatient settings, inflammatory eye diseases occupy the leading position, accounting for approximately 16 million cases annually in the Russian Federation. The limited efficacy of topical pharmacotherapy for ulcerative and dystrophic corneal diseases, along with the risk of adverse reactions, necessitates the search for new treatment methods. One such approach is the use of therapeutic ion-exchange contact lenses (TICLs).

Purpose: To evaluate the efficacy of therapeutic ion-exchange contact lenses (TICLs) as part of combination therapy for inflammatory and dystrophic corneal diseases.

Materials and methods. A clinical study was conducted in 79 patients (79 eyes) with corneal pathology between March and April 2024. Depending on the treatment approach, patients were divided into two groups. The main group (n = 41) included 26 patients with ulcerative stromal keratitis and 15 with bullous keratopathy. The comparison group (n = 38) included 24 patients with ulcerative stromal keratitis and 14 with bullous keratopathy. In the main group, in addition to standard pharmacotherapy, “Universal TICLs” were applied 1–2 times at 3–4-day intervals depending on disease severity and clinical dynamics. The comparison group received only topical pharmacotherapy. At baseline and 1, 3, 7, 14, and 30 days after TICL application, all patients underwent visual acuity testing, autorefractometry, pneumotonometry, slit-lamp biomicroscopy, anterior segment optical coherence tomography (AS-OCT), indirect binocular ophthalmoscopy, ultrasound examination, and pachymetry. The observation period was one month. The primary endpoints were complete epithelialization of the ulcer defect in patients with stromal keratitis and corneal thinning in patients with bullous keratopathy.

Results. Incorporation of TICLs into the comprehensive treatment of ulcerative keratitis accelerated epithelialization of the ulcer defect by 1.8 times and reduced hospitalization duration by 1.5 times. A smaller, less dense corneal opacity was observed, accompanied by stable improvement in visual function. In bullous keratopathy, combined therapy with TICLs relieved corneal syndrome, reduced corneal edema, increased transparency, and restored normal corneal thickness, leading to improved visual function compared with conservative pharmacotherapy alone.

Conclusion. The use of therapeutic ion-exchange contact lenses in the management of inflammatory and dystrophic corneal diseases shortens rehabilitation time, does not cause complications, and is characterized by an absence of adverse effects, making this approach suitable for routine clinical practice.

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