Epidermal growth factor (
EGF) is known to promote corneal epithelial wound healing in experimental scrape and
keratectomy models. We studied its efficacy in treating
alkali-burned epithelial ulceration.
EGF induced
hyperplasia and cell proliferation to resurface the denuded and denatured corneal stroma, but it did not prevent recurrent erosions. A combination of
EGF with
fibronectin (Fn) was noted to enhance epithelial defect closure after
alkali burns of the cornea and was seen to prevent recurrent erosions. Histopathologic examination of these corneas revealed marked leukocytic infiltration of the
alkali-burned corneal stroma. To find ways to retard this inflammatory response, we studied the role of topical
steroids and their efficacy when used with
EGF, Fn, and
laminin (Ln) in the management of
alkali-burned corneas. Use of
steroids decreased the incidence of recurrent erosions and
corneal perforations. Histologically,
steroids markedly decreased the leukocytic infiltration of stromal tissue, thereby retarding the collagenolysis. Topical
steroids used with
EGF and
fibronectin were seen to promote epithelial
wound closure and to prevent recurrent erosions in
alkali-burned corneas. Combinations of
EGF,
fibronectin, and
steroids may have a place in the treatment of clinical corneal
alkali burns.