Topical Infliximab for the Treatment of Sterile Corneal Melt
Corneal melt is a complication that could affect very ill eyes and lead to the thinning of the cornea (the clear window covering of the eyes). This thinning can lead to severe consequences such as the leakage of the liquid inside the eye (ocular perforation), or even blindness. Corneal melt can be caused by certain infections or as a sterile process. This project only includes patients with a sterile corneal melt (without an infection) caused by diseases such as rosacea, Sjogren's syndrome, rheumatoid arthritis, Crohn's disease, Stevens Johnson syndrome, as well as toxic epidermal necrolysis or mucous membrane pemphigoid. Infliximab is an antibody against tumour necrosis factor alpha and has been used to treat or prevent corneal melt in certain patients with inflammatory of auto-immune disease. In this situation, infliximab was used intravenous (using veins) in order to treat the whole body. This study's hypothesis is that infliximab can safely be used as eye drops for the treatment of sterile corneal melt.
• Age 18 to 80 years;
• Any degree of active sterile corneal melting , as documented by slit-lamp examination, showing an epithelial defect and stromal thinning;
• Negative work-up for local and systemic infectious causes
• Negative corneal cultures (may show growth of common contaminants)
• Capable of providing informed consent;
• Capable of administering eye drops either themselves or through a caregiver.