Ocular surface disease in many instances is a chronic condition that is multifactorial in its causes, symptoms and signs. In chronic ocular surface disease (dry eye disease) there can be epithelial cell damage, hyperosmotic tear film (aqueous layer) and elevated MMP-9s indicating inflammation.
The goal of the physician is to optimize the corneal surface environment to create the opportunity for the body to return to homeostasis. This will require systemic and topical therapies based on the individual patient’s needs. Providing a healthy epithelial surface allows for more moisture on the eye, allowing the inflammatory-causing hypertonic tear film to return to an isotonic state. Healthy epithelial cells are required for anchoring points of the patient’s mucin molecules and holding water on the ocular surface.
How to return to a healthy corneal surface:
To provide a patient’s best vision and comfort, a healthy ocular surface requires healthy epithelial cells. Healthy epithelial cells provide anchor points for mucin or OTC hyaluronan drops to hold water on the ocular surface.
Aril® acts as a substrate for cellular migration for epithelial cells. The Aril® peptides and GAGs stimulate the body’s own wound healing cascade, inhibit scarring, are anti-inflammatory (after the initial wound healing inflammation) and are anti-angiogenic. Aril’s® anti-inflammatory properties and epithelial cell regeneration properties allow for more mucin to develop and adhere to the epithelial layer.
If the patient is not producing enough mucin, an OTC drop containing hyaluronan (HA) can supplement this deficiency. HA drops are known to hold up to 1000 times their weight in water. HA is a molecule very similar to mucin and binds to CD-44 receptors on healthy epithelium.
After creating a healthy epithelial surface and more water is retained on the eye, it will be important to institute therapies that improve goblet cell secretion of mucins. Meibomian gland secretions of lipids will further enhance the health of the tear film and cornea. This would include a lid cleaning protocol, nutraceuticals, moist heat therapy, moisture retention glasses.
Aril® is a room temperature stable allograft derived from human placental tissue collected from consenting donors. Post-decellularization & stabilization, Aril® is packaged in a double pouch packaging system and subjected to low dose gamma irradiation. Aril® is an allograft tissue intended for homologous use regulated by 21 CFR Part 1271 and Section 361 of the PHS Act.
If you have questions about Aril, please check out frequently asked questions.