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PubMed2002

Immune responses to therapeutic proteins in humans--clinical significance, assessment and prediction.

There is a large and increasing number of therapeutic proteins approved for clinical use and many more undergoing preclinical studies and clinical trials in humans. Most of them are human or 'humanized' recombinant molecules. Virtually all therapeutic proteins elicit some level of antibody response, which in some cases, can lead to potentially serious side effects. Therefore, immunogenicity of therapeutic proteins is a concern for clinicians, manufacturers and regulatory agencies. In order to assess immunogenicity of these molecules, appropriate detection, quantitation and characterization of antibody responses are necessary. Immune responses to therapeutic proteins in conventional animal models has not been, except in rare cases, predictive of the response in humans. In recent years there has been a considerable progress in development of computational methods for prediction of epitopes in protein molecules that have the potential to induce an immune response in a recipient. Initial attempts to apply such tools in early development of therapeutic proteins have already been reported. It is expected that computer driven prediction followed by in vitro and/or in vivo testing of any potentially immunogenic epitopes will help in avoiding, or at least minimizing, immune responses to therapeutic proteins.

Antigens↗

PubMed2004

Therapeutic potential of hammerhead ribozymes in the treatment of hyper-proliferative diseases.

The limited efficacy of current therapeutic approaches for a number of socially relevant human diseases such as cancer and cardiovascular pathologies, has required the exploration of alternative and more effective therapeutic strategies. In the last two decades, nucleic acid based drugs have emerged as an attractive and novel alternative with great therapeutic potential. Among these molecules, hammerhead ribozymes were the first to be extensively studied and predicted to be of potential practical utility. Hammerhead ribozymes are catalytic RNA molecules capable of inducing the site-specific cleavage of a phosphodiester bond within an RNA molecule. Thus, they can be used to reduce the intracellular level of a specific mRNA coding for a protein which affects cellular metabolism or environment, causing disease. As hammerhead ribozymes can be engineered to reduce the level of virtually any mRNA, they have a very broad applicability. Among the several pathological conditions amenable for a hammerhead ribozyme based therapeutic approach, we focused our attention on pathologies sustained by a dis-regulated and excessive cellular proliferation, being sure to properly demonstrate their usefulness. Trying to be as objective as possible in regard to the feasibility of hammerhead ribozyme employment as therapeutics, a technical section, describing some of the unresolved problems in this field, has been also included. Although some aspects of hammerhead ribozymes as therapeutics can and should be optimized, the encouraging results displayed so far fully justifies further efforts, economic and scientific, to bring them closer to the clinical practice.

Animals↗

PubMed2003

Therapeutic HIV vaccines.

Antiretroviral therapy with potent combinations of drugs has been responsible for a significant decline in the occurrences of AIDS defining conditions and death in the developed world. However, therapy requires life-long use and is complicated by relatively high failure rates, significant toxicities, adherence difficulties and the development of resistance. The combination of these complications of therapy and the availability of this treatment to only 1 in 20 of the estimated 34 million people infected world wide has prompted us to reconsider the current strategies for achieving the goals of HIV therapy. A more rational approach to therapeutic interactions is needed, particularly with respect to therapy in the developing world, with the focus shifted towards maintaining relative viral control over the long term. One potential mechanism to attain viral control over the long term is the use of therapeutic vaccines. This chapter will review the scientific rationale for therapeutic HIV-1 vaccines and the vaccines that have been evaluated as a therapeutic to date including recombinant envelope glycoproteins, inactivated envelope depleted virus, regulatory proteins such as Tat, cytokines such as IFN-(alpha), DNA vaccines, and live viral vectors. Although the future role of therapeutic vaccines in the treatment of HIV-1 remains to be determined, at a minimum this immunomodulatory approach will provide new insights into fundamental viral-host cell interactions and the pathogenesis of HIV-1. Yet even more notable, is that, if successful, a therapeutic vaccine product would be inexpensive and rapidly exportable representing a treatment strategy for people living with HIV infection worldwide.

AIDS Vaccines↗

PubMed1998

Use of the therapeutic footwear benefit among diabetic medicare beneficiaries in three states, 1995.

OBJECTIVE: To determine the extent to which Medicare provided reimbursement for therapeutic footwear to diabetic Medicare beneficiaries in Washington, Alaska, and Idaho in 1995. RESEARCH DESIGN AND METHODS: Using inpatient, outpatient, and durable medical equipment claims data, we selected a cohort of diabetic Medicare beneficiaries. Therapeutic footwear claims were identified using a set of billing codes intended only for the diabetes footwear benefit. People at "high risk" or "possibly increased risk" for foot problems who might benefit from therapeutic footwear were identified using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes in any of the databases. RESULTS: Among 608,804 beneficiaries, 10.2% (62,170) met the inclusion criteria for diabetes. Of the diabetic beneficiaries, 13.0% (8,079) had at least one "high risk" diagnosis, and 14.0% (8,686) had at least one "possibly increased risk" diagnosis. The percentage of diabetic beneficiaries with therapeutic footwear claims was 2.9% among those with diagnoses high risk, 0.7% among those with diagnoses indicating possibly increased risk, and 0.1% among those with no diagnosis from the list. Altogether, only 0.6% of beneficiaries meeting the diabetes case ascertainment criteria had a therapeutic footwear claim in 1995. CONCLUSIONS: Few diabetic Medicare beneficiaries in Washington, Alaska, and Idaho had claims for reimbursement for therapeutic footwear in 1995. The low utilization of the footwear benefit may represent an important opportunity to improve care for Medicare beneficiaries with diabetes. Further work should be done to characterize the use of the benefit in other regions and to assess whether the low level of usage reflects underutilization.

Age Factors↗

PubMedDate not supplied

Methodology for the evaluation and measurement of therapeutic progress.

When a candidate drug is likely to become available to prescribers and healthcare policy makers, evaluation of therapeutic progress moves forward in two stages. First, the level of expected therapeutic progress must be established. This first stage requires the determination of therapeutic needs and the comparison of these against the results of the clinical studies that will form the basis of the marketing authorisation of the drug. This determination helps anticipate the therapeutic progress that is attributable to the approved use of the new drug. The second stage of the process, the evaluation of the actual therapeutic progress, involves therapeutic drug monitoring and bases itself on observation. Since such observational data are intended to challenge the initial hypotheses and uncertainties (in terms of benefits and risks), goals and methods must be laid out before the drug becomes available to the general public.

Clinical Trials as Topic↗

PubMed2007

Acid sensing ion channels--novel therapeutic targets for ischemic brain injury.

Ischemic stroke is a leading cause of death and long-term disability in the United States. Unfortunately there is no effective therapeutic intervention other than the use of thrombolytics, which has a limited therapeutic time window of approximately 3 h and the potential side effect of intracranial hemorrhage. The absence of neuroprotective therapy is particularly apparent following the failure of multiple clinical trials using glutamate antagonists as therapeutic agents. Understanding the detailed biochemical changes associated with brain ischemia and the cellular mechanisms involved in ischemic brain injury are critical for establishing new and effective neuroprotective strategy. Dramatically decreased tissue pH, or acidosis, is a common feature of ischemic brain, and has been suggested to play a role in neuronal injury. However, the detailed cellular and molecular mechanisms of such acid induced injury remain elusive. The recent finding that acidosis activates a distinct family of cation channels, the acid-sensing ion channels (ASICs), in both peripheral and central neurons has dramatically changed the landscape of brain ischemia neurochemistry and provided a novel therapeutic target. In CNS neurons, lowering extracellular pH to the level commonly seen in ischemic brain activates inward ASIC currents resulting in membrane depolarization. In the majority of these neurons, ASICs are also permeable to Ca2+. Therefore, activation of these channels induces an increase of [Ca2+]i. Incubation of neurons with acidic solutions reproduces Ca2+-dependent neuronal injury independent of glutamate receptor activation. The acid-induced currents, membrane depolarization, [Ca2+]i increase, and neuronal injury can be inhibited by the blockade of ASIC1a. In focal ischemia, ASIC1a blockade, or ASIC1a gene knockout both protect brain from injury. The blockers of ASIC1a also demonstrate a prolonged therapeutic time window, beyond that of the glutamate antagonists. Thus, Ca2+-permeable ASIC1a may represent a novel therapeutic target for ischemic brain injury.

Acid Sensing Ion Channels↗

PubMed1994

Culture and community in the therapeutic community: implications for the treatment of recovering substance misusers.

This paper critically discusses the conceptualization and structure of the therapeutic community employed for the treatment of substance misuse in America. The predominant American model, the concept-house model, is criticized on the grounds that the therapeutic milieu of these treatment agencies is contaminated by their subordinance to the influences of the larger American society. These influences include: the predominance of the medical model, the agency as an agent of service delivery, capitalism and inequity, implicit views of human nature, and stratification of social structure. The thesis of this paper is that treatment personnel in therapeutic communities must develop increased sensitivity to the larger cultural factors which influence the construction of the therapeutic community. It is argued that problems within the American culture play a significant role in the etiology of substance misuse. Therefore, treatment personnel must be careful to avoid constructing therapeutic communities which too closely mirror the larger culture. This cultural influence in therapeutic communities functions to maintain long-term substance misuse problems within the individual and the nation.

Behavior, Addictive↗

PubMed2003

Neural precursor cells as carriers for a gene therapeutical approach in tumor therapy.

Conventional therapeutical approaches such as surgery, radiotherapy, or chemotherapy have been shown to be rather unsuccessful in the treatment of infiltrative growing tumors such as the malignant glioblastoma multiforme. Thus, new therapeutical strategies have to be developed that are suitable for inducing cell death also in migrating tumor cells. These new therapeutical stategies include cell and/or gene therapeutical approaches. We demonstrate that glial-restricted progenitor cells as well as embryonic stem cell-derived neural stem cells belong to cell populations applicable to such therapeutical concepts. Both cell types can be efficiently transduced using a third-generation high-capacity "gutless" adenoviral vector, and show a tropism for the F98 glioma cells by migrating towards a spheroid of F98 glioma cells with a tendency to form a barrier around the tumor spheroid in an in vitro tumor confrontation model. Moreover, in a migration assay, secretion products of glial-restricted precursor cells have shown a potency to inhibit the migratory activity of glioma cells in vitro. In vivo, F98 glioma cell-derived tumor formation in the right striatum resulted in migration of glial as well as neural precursor cells towards the tumor area when cotransplanted in the corpus callosum of the contralateral hemisphere. After arrival, both cell types surround the tumor mass and even invade the experimentally induced tumor. These data indicate that glial-restricted as well as embryonic stem cell-derived neural precursor cells are good candidates as carriers for an ex vivo gene therapeutical approach in tumor therapy.

Adenoviridae↗

PubMed2004

A DNA vaccine against extracellular domains 1-3 of flk-1 and its immune preventive and therapeutic effects against H22 tumor cell in vivo.

AIM: To construct a DNA vaccine against extracellular domains 1-3 of fetal liver kinase-1 (flk-1), and to investigate its preventive and therapeutic effect against H22 cell in vivo. METHODS: Flk-1 DNA vaccine was produced by cloning extracellular domains 1-3 of flk-1 and by inserting the cloned gene into pcDNA3.1 (+). Fifteen mice were divided into 3 groups and inoculated by vaccine, plasmid and saline respectively to detect specific T lymphocyte response. Thirty Mice were equally divided into preventive group and therapeutic group. Preventive group was further divided into V, P, and S subgroups, namely immunized by vaccine, pcDNA3.1 (+) and saline, respectively, and attacked by H22 cell. Therapeutical group was divided into 3 subgroups of V, P and S, and attacked by H22, then treated with vaccine, pcDNA3.1 (+) and saline, respectively. The tumor size, tumor weight, mice survival time and tumor latency period were compared within these groups. Furthermore, intratumoral microvessel density (MVD) was assessed by immunohistochemistry. RESULTS: DNA vaccine pcDNA3.1 (+) flk-1-domains 1-3 was successfully constructed and could raise specific CTL activity. In the preventive group and therapeutic group, tumor latency period and survival time were significantly longer in vaccine subgroup than that in P and S subgroups (P<0.05); the tumor size, weight and MVD were significantly less in vaccine subgroup than that in P and S subgroups (P<0.05). The survival time of therapeutic vaccine subgroup was significantly shorter than that of preventive vaccine subgroup (P<0.05); the tumor size, and MVD of therapeutic vaccine subgroup were significantly greater than that of preventive vaccine subgroup (P<0.05). CONCLUSION: DNA vaccine against flk-1 domains 1-3 can stimulate potent specific CTL activity; and has distinctive prophylactic effect on tumor H22; and also can inhibit the tumor growth in vivo. This vaccine may be used as an adjuvant therapy because it is less effective on detectable tumor.

Animals↗

PubMedDate not supplied

Radiation-induced apoptosis: predictive and therapeutic significance in radiotherapy of prostate cancer (review).

Current therapy for advanced prostate cancer is hampered by the propensity of the disease to progress from an androgen-dependent state to an androgen-independent state. Current treatment for advanced disease is palliative. Therefore, the therapeutic goal for prostate cancer treatment today is to arrest the disease at an early state when it is still localized to the gland. The standard treatment for clinically localized disease is radical prostatectomy or radiation therapy by way of external beam irradiation or local radioactive seed implants (brachytherapy). In advanced disease, the use of radiation therapy is limited to palliation of pain secondary to bone metastases and for spinal cord compression. Tracking residual disease and predicting outcome is limited to following the level of prostate specific antigen (PSA) production, evaluating for bone or solid organ metastasis, and analyzing their preoperative clinical stage, PSA and Gleason's score. Apoptosis as a molecular process of genetically regulated cell death has a critical endpoint that coincides with the goal of successful treatment of human malignancies. Since in cancer treatment the therapeutic goal is to trigger tumor-selective cell death, activation of the apoptotic pathway in prostatic tumor cells offers attractive and potentially effective therapeutic targets. As our understanding of the vital role of apoptosis in the development and growth of the prostate gland has expanded, numerous genes that encode apoptotic regulators have been identified that are severely impaired in prostate tumors. Human prostate cancer cells undergo apoptosis in response to androgen ablation, chemotherapeutic agents and ionizing irradiation. The expression of apoptotic modulators within individual prostate tumors appears to correlate with the cancer cell's sensitivity to traditional therapeutic modalities, including radiotherapy. No strict correlation between radiation-induced apoptosis and longevity of prostate cancer patients has emerged, possibly because the ability to achieve an initial remission alone does not adequately predict long-term outcome and patient survival. In this review we summarize the current understanding of the effects of radiation therapy on prostatic tumor cells within the context of the therapeutic significance of radiation-induced apoptosis in the effective elimination of androgen independent prostate cancer cells. As we enter a new millenium, identification of distinct molecular markers predictive of therapeutic response of prostatic tumors to radiation therapy may afford alternative prognostic indicators in optimizing our treatment protocols for advanced disease.

Apoptosis↗

PubMed2004

[Unattended automated titration to determine therapeutic continuous positive airway pressure in patients with obstructive sleep apnea].

Recently, devices which use a new technology that automatically titrates positive airway pressure have become available. Such devices continually adjust the pressure to maintain airway patency. In this paper, unattended automated titration to determine the therapeutic continuous positive airway pressure (CPAP) in patients with obstructive sleep apnea was evaluated to ascertain of it was a feasible titration to determine the therapeutic CPAP. Thirty patients participated in this study with obstructive sleep apnea syndrome defined by an apnea hypopnea index > 20/h. Automated titration during full polysomnography was performed in the hospital using auto CPAP devices (Autoset T, RESMED Co, Australia). During titration, there was no direct supervision by a technician. The titration method was as follows. Data obtained during the use of auto CPAP devices and polysomnography were used to provide a fixed single pressure for subsequent treatment. After determining the therapeutic continuous positive airway pressure, the efficacy of the patient's CPAP device was reconfirmed during full polysomnography. The results were, 1) Proper fixed single therapeutic pressure could be determined with this unattended automated titration, consequently apnea and sleep structure could be improved (Total sleep time, Sleep efficiency, %Stage 3 + 4, Apnea index, Apnea hypopnea index, Arousal index, Lowest SpO2, and Duration of SpO2 less than 90% were improved statistically (p < 0.05)). 2) The 95th percentile airway pressure of the auto CPAP device should be applied for the therapeutic pressure. 3) Automated titration during full polysomnography should be performed using auto CPAP devices. 4) After determining the therapeutic CPAP, the efficacy of the patient's CPAP device should be reconfirmed during full polysomnography. 5) This method of titration was useful at the institution without attendant technician intervention.

Automation↗

PubMedDate not supplied

Therapeutic occupation: a definition.

This article builds on prior work and defines terms basic to the profession of occupational therapy. The prior work defined occupation as the relationship between occupational form and occupational performance and defined related terms, such as meaning, purpose, developmental structure, impact, and adaptation. This article shows how these terms relate to therapeutic occupation, a special type of occupation. Therapeutic occupation through occupational synthesis is the core of occupational therapy. Occupational synthesis is the design of the occupational form by the occupational therapist in collaboration with the recipient of services to advance therapeutic evaluation or achieve a therapeutic goal. Therapeutic occupation, then, is meaningful, purposeful occupational performance leading to assessment, adaptation, and compensation, all in the context of occupational synthesis. Finally, the idea of therapeutic occupation through occupational synthesis is related to frames of reference and models of practice in occupational therapy today.

Adaptation, Psychological↗

PubMed1998

[Controversies connected with the therapeutic approach in palpebral epitheliomas].

OBJECTIVE: We try to clarify some controversies related to the palpebral epitheliomas, controversies related to the therapeutical applied attitude (surgery, radiotherapy or the association of the two therapeutical methods), to the indications and contraindications of their application. MATERIAL AND METHOD: It is a review study of the Military Hospital and Oncologic Institute Cluj-Napoca casuistry between 1984-1994, which comprises 244 patients with palpebral epitheliomas, histologically confirmed. This casuistry was followed taking into consideration the age, sex, histological type, anatomo clinical presentation, TNM clinical stage, the localisation of the tumor, the type of the applied treatment, complications, healing and the therapeutical failures. RESULTS: The efficiency of the applied therapeutical methods was considered related to their obtained results to the therapeutical failures. The rate of healing at 5 years was 90.57% for the whole group. CONCLUSIONS: 1. The two methods of treatment seems to be equally sensible concerning the therapeutical efficiency in stages I and II. 2. In the advanced stages (III and IV) our option is for mixing the two methods. An optimum treatment for each patient is possible only if there is a close cooperation between the ophthalmologist-surgeon, plastic surgeon and the radiation oncologist.

Adult↗

PubMed1999

[SEB--an instrument for the assessment of therapeutic processes in inpatient psychotherapy].

The Stationserfahrungsbogen (Record Sheet and Questionnaire on the experience of the inpatient therapeutic process--SEB) is an instrument to assess process aspects during inpatient psychotherapy. Weekly presentation and completion of the sheet shows changes in selected aspects of patient experience. 38 items cover the following aspects (scales): relations with the therapeutic team, relations with the individual therapist, group climate (cohesion), attention from fellow patients, intensity of treatment, therapeutic rules, self-efficacy. The questionnaire can be applied in clinical and research areas and is also useful for quality management of therapeutic institutions. Single-case studies using SEB facilitate clinical discussion and understanding of therapeutic processes. In psychotherapy research the instrument can be used to assess common and specific factors of therapeutic effects. By comparison with norm scores and SEB can also be used for the evaluation of process and outcome quality. The questionnaire can be applied economically and with good patient compliance. It is objective and has clinical validity and is of great informative value. Internal consistency of the individual scales is good to satisfactory.

Humans↗

PubMed2001

[Therapeutic cloning--future medicine or an ethical dead end?].

BACKGROUND: Treatment with stem cells has given promising results in animal experiments and may be relevant in a variety of diseases, including heart disease, cancer, diabetes, Parkinson's disease and Alzheimer's disease. However, the use of pluripotent stem cells grown from blastocysts available after in vitro fertilization or from fetuses raises difficult issues in medical ethics. The same goes for therapeutic cloning. RESULTS: Attitudes to this mode of treatment differ from country to country. In Britain, Parliament has accepted therapeutic cloning (February 2001), while the German Bundestag has banned the procedure. The EU Parliament has recommended European countries not to allow therapeutic cloning, and President George W. Bush takes a more critical stand than did the Clinton administration. DISCUSSION: The debate over embryonal cells and therapeutic cloning involves both scientists and politicians. In Norway, the Biotechnology Advisory Board wants to open up for research on fertilized eggs and for therapeutic cloning. The Storting, Norway's legislature, will have to reach a decision on these issues when the Biotechnology Act come up for revision, probably in 2002. In the debate in Norway, it has been claimed that accepting therapeutic cloning would be a violation of a traditional western norm: Man should always be an end onto himself, never be used as an instrument to other ends. Furthermore, some scientists think that one should use adult stem cells from adults--this also because the procedure seems less risky. Bone marrow transplantation with autologous bone marrow stem cells has been used for 30 years, and recent research has disclosed that such stem cells may be reprogrammed, for instance from bone marrow stem cells to nerve cells.

Adult↗

PubMedDate not supplied

[Is therapeutic drug monitoring (TDM) in paediatric patients necessary?].

There is increasing discussion about the clinical usefulness of routine TDM of selected drugs in paediatrics. Routine TDM is performed as a way to individualize dosing requirements so as to achieve "therapeutic" concentrations in all patients, independently of age and individual drug response. The therapeutic ranges established for most drugs are based upon studies performed in adults. Extrapolation of these ranges to paediatric patients, especially to neonates, is questionable because drugs disposition and pharmacodynamics differ in this population compared to adults. The scepticism of the value of routine TDM in paediatric patients concerns antiepileptic drugs and digoxin. Recently also the value of vancomycin TDM in neonates has been the subject of discussion, resulting in new recommendation for dosing schedule in this age group. Therapeutic monitoring of methotrexate, especially administered in high doses in anticancer therapy is not questioned. Aminoglycosides have an extremely important role in paediatric antimicrobial therapy. They are still frequently used in the neonatal period. The rationale for monitoring of aminoglycosides is a narrow therapeutic range resulting in risk of oto- and nephrotoxicity, and large inter- and intra-subject variation in pharmacokinetics. Routine TDM is not recommended for paediatric patients (other than neonates) with normal renal function and without chronic illnesses associated with changes in pharmacokinetics of aminoglycosides. In these patients the peak and trough concentrations are within the therapeutic range using standard dosing regimes. Therapeutic monitoring of aminoglycosides is still obligatory in neonates, especially in premature and low birthweight neonates because of particularly wide inter-patient and intra-patient pharmacokinetic variability and risk of oto- and nephrotoxicity.

Aminoglycosides↗

PubMed1975

[Pharmacopsychologic studies on normal subjects for the prediction of the therapeutic efficiency of psychotropic drugs].

The paper deals with some basic problems and possibilities of predicting the therapeutic efficiency of psychotropic drugs from studies in normal humans. Comparing drug studies with normal subjects and patients it seems evident that from a methodological and economical point of view studies with normal subjects have many advantages. However, the practical importance of drug studies with normal subjects is limited unless the therapeutic efficiency of a drug can be predicted. There are some arguments which deny the possibility of prediction, e.g. referring to the lack of comparability of dosages, administration regimens, situational parameters and psychosomatic states between normal subjects and patients. Discussing such arguments it is pointed out that perfect comparability of all these factors is not a necessary prerequisite of prediction. A number of theoretically possible models for predicting therapeutic efficiency is suggested. For some of them there already exists some empirical evidence. The first model takes into account the inter- and intra- individual variability of behavior. It is suggested that a state corresponding to the psychosomatic state of patients be approximated, or simulated, in the normal subjects by suitable selection procedures of subjects or by manipulation of the experimental conditions. The usefulness of such a model for predicting therapeutic efficiency has been shown in many studies with anti-anxiety agents. In another model the drug profiles of normal subjects and patients are compared and the prediction is based upon drug effects in normal subjects which can also be seen in patients and which have a high correlation to the patients' improvement. A further model assumes that improvement is partly the result of learning processes. The prediction of therapeutic efficiency is, therefore, based upon the properties of a drug to facilitate or inhibit learning processes. The final two models proposed, predict limitations of therapeutic efficiency. The one model takes into account side-effects; the other the variability of drug response due to situational and person-parameters.

Humans↗

PubMed2002

[Preliminary study about therapeutical contact lenses use].

THE AIM OF THE PAPER: The goal of the paper is to emphasize the advantages of the application of therapeutical contact lenses as compared to the eye patch. MATERIAL AND METHOD: There have been taken into study 42 patients-43 eyes, to whom we applied therapeutical contact lenses. RESULTS AND DEBATES: In the studied cases there have been taken into discussion the type of corneal diseases, the treatment prescribed, the period of time that the lenses have been worn and the possible complications. There have been prevailed herpetic keratopathies (12 cases), edemato-bullous keratopathies--aphakic and pseudophakic (12 cases), followed by recurrent corneal erosions (4 cases), full thickness corneal and corneoscleral lacerations (4 cases) and alkali chemical corneo-conjunctival burns of II-nd/III-rd degree and III-rd degree. CONCLUSIONS: 1. The wearing of therapeutical contact lens determined the improvement of the pain, of the eye discomfort and the corneal epithelium healing. 2. A therapeutical alternative clearly superior to the occlusive eye patch, the therapeutical contact lens limits the indications of tarsorrhaphy and conjunctival flap. 3. The therapeutical contact lens find their usefulness in a tectonic aim until the final surgical solution.

Contact Lenses↗