scholarly journals Small graft, simultaneous amniotic membrane transplantation, temporary lateral tarsorrhaphy and autologous serum improves outcome of penetrating keratoplasty in congenital aniridia with aniridia associated keratopathy

2019 ◽  
Vol 97 (S263) ◽  
Author(s):  
Fabian Fries
Keyword(s):  
Amniotic Membrane ◽  
Penetrating Keratoplasty ◽  
Autologous Serum ◽  
Amniotic Membrane Transplantation ◽  
Congenital Aniridia

scholarly journals Stabilization of Bilateral Progressive Rheumatoid Corneal Melt with Infliximab

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sheelah F. Antao ◽  
Tariq Ayoub ◽  
Hasan Tahir ◽  
Dipak N. Parmar
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Amniotic Membrane ◽  
Conventional Treatment ◽  
Penetrating Keratoplasty ◽  
Amniotic Membrane Transplantation ◽  
Cyanoacrylate Glue ◽  
Ocular Discomfort ◽  
History Of ◽  
Ulcerative Keratitis

Purpose. To report the use of infliximab in the rapid stabilization of a case of progressive, bilateral rheumatoid peripheral ulcerative keratitis (PUK) that failed to respond to conventional immunosuppressive therapy.Methods. A single interventional case report.Results. A patient with rheumatoid arthritis presented with bilateral PUK following a 2-month history of ocular discomfort and redness. His systemic prednisolone (PDN) and methotrexate (MTX) were increased and, despite an initial favorable response, bilateral recurrent corneal perforations ensued. Both eyes underwent cyanoacrylate glue repair, amniotic membrane transplantation (AMT), and penetrating keratoplasty (PKP). Recurrence of the disease and bilateral perforations of the second PKP in both eyes prompted administration of intravenous infliximab immediately after the fourth PKP. The disease activity rapidly settled in both eyes, and at eighteen-month followup, after 12 infliximab infusions, the PUK remains quiescent with no further graft thinning or perforation.Conclusion. Infliximab can be used to arrest the progression of severe bilateral rheumatoid PUK in cases that are refractory to conventional treatment.

scholarly journals An Attempt to Optimize the Outcome of Penetrating Keratoplasty in Congenital Aniridia-Associated Keratopathy (AAK).

2021 ◽  
Author(s):  
Christian Joe Farah ◽  
Fabian Fries ◽  
Lorenz Latta ◽  
Barbara Käsmann-Kellner ◽  
Berthold Seitz
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Autologous Serum ◽  
Eye Drops ◽  
Logrank Test ◽  
Congenital Aniridia ◽  
Group 2 ◽  
Group 1

Abstract Purpose To propose an optimized microsurgical and medical approach to reduce the risk of complications after penetrating keratoplasty (PKP) in patients with aniridia-associated keratopathy (AAK). Methods Retrospective observational case series of 25 PKP performed in 16 patients with AAK. Preoperative indications were endothelial decompensation and vascularised scars (68%) or graft failure (32%) due to limbal stem cell deficiency. The optimized approach included a combination of a small corneal graft size (around 7.0mm), interrupted 10-0-Nylon sutures, simultaneous AMT as a patch, large bandage contact lens, temporary lateral tarsorrhaphy, postoperative autologous serum eye drops, and systemic immunosuppression. Main outcome measures included: Visual acuity, transplant survival and complications encountered during follow-up of 107 weeks on average. Results A complete modified keratoplasty scheme was used in 10 of 25 PKP (group 1), while at least one of the modifications was missing in the other 15 PKP (group 2). After 8 weeks follow-up, the epithelium was closed in 23 eyes. Visual acuity improved in 19 eyes at 6 months follow-up, and remained stable in 6 eyes. None of the eyes showed a decrease in visual acuity. At the last post-operative follow-up, this visual improvement persisted in 14 eyes and graft survival rate after 156 weeks (3 years) was 69% in group 1 vs. 44% in group 2 (p = 0.39, logrank test). Secondary corneal neovascularisation (8%), scarring (4%), ulcer (4%) or graft rejection (8%) happened mostly in the second group which was missing at least one of the suggested modifications. Conclusions PKP in congenital aniridia must be considered as a high-risk keratoplasty. An optimized therapeutic approach seems to be promising in order to reduce the postoperative complication rate in these most difficult eyes.

scholarly journals Amniotic membrane transplantation for persistent corneal epithelial defects in eyes after penetrating keratoplasty

Eye ◽  
2008 ◽  
Vol 23 (4) ◽  
pp. 840-848 ◽  
Author(s):  
B Seitz ◽  
S Das ◽  
R Sauer ◽  
D Mena ◽  
C Hofmann-Rummelt
Keyword(s):  
Amniotic Membrane ◽  
Penetrating Keratoplasty ◽  
Amniotic Membrane Transplantation ◽  
Corneal Epithelial

scholarly journals Experience of using a thrombofibrin clot of plateletrich plasma in ulcerative lesions of the cornea

2022 ◽  
Vol 14 (4) ◽  
pp. 15-21
Author(s):  
E. V. Fedoseeva ◽  
E. V. Chentsova ◽  
N. V. Borovkova ◽  
I. N. Ponomarev ◽  
V. A. Vlasova ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Platelet Rich Plasma ◽  
Autologous Blood ◽  
Complete Healing ◽  
Autologous Serum ◽  
Amniotic Membrane Transplantation ◽  
Corneal Ulcers ◽  
Severe Burns ◽  
Surgical Methods ◽  
Extensive Damage

Purpose: to study the effectiveness of the use of thrombofibrin clot of platelet-rich plasma (PRP) in patients with corneal ulcers. Material and methods. A clinical study, conducted by the Department of Traumatology and Reconstructive Surgery of Helmholtz National Medical Research Center of Eye Diseases, involved 20 patients, aged from 22 to 82, with corneal ulcers of inflammatory and burn genesis more than 100 microns deep. All patients got coated with a thrombofibrin PRP clot from autologous blood. Prior to the study, all patients received standard treatment for 2 weeks to 3 months, including multiple amniotic membrane coating, with no effect. The thrombofibrin clot was produced by the Scientific Department of Biotechnology and Transfusiology of the N.V. Sklifosovsky Research Institute for Emergency Medicine. The ready clot was placed on the surface of the cornea and covered with an amniotic membrane. The membrane was fixed to the episclera along the border of the limb with a circular suture, whereupon autologous serum was injected along the limb in 4 quadrants, to be followed by temporary lateral blepharography. Results. On the 2nd day following the procedure, the patients noted a decrease in lacrimation and pain in the operated eye. As shown by optical coherence tomography, the average depth of the corneal ulcer at the beginning of the study in all patients was 129 ± 28.5 microns. On the 5th day, the depth lowered to an average of 71 ± 32.6 microns, and on the 10th day, to 23.3 ± 15.1 microns. In 7 patients (35%), complete healing of the defect was observed on the 15th day, while in 9 patients (45%) it was stated between the 16th and the 20th day. Thus, the average time of healing of the ulcer with complete epithelization occurred was 15 days. In four patients with the consequences of severe burns (20%), the ulcer did not heal due to extensive damage to the limbal zone. Conclusion. The use of a thrombofibrin PRP clot in combination with amniotic membrane transplantation allows achieving a stable and fairly rapid healing of corneal ulcers of various origins. However, this method is ineffective in patients with limbal cell insufficiency, severe burns and extensive damage to the limbal zone. In such cases, it is advisable to use more radical surgical methods, such as buccal or limbal cell transplantation, or allolimbal transplantation.

scholarly journals Amniotic membrane transplantation in a patient with impending perforated corneal ulcer caused by Streptococcus mitis: a case report

2019 ◽  
Author(s):  
Fang-Chi Hsiao ◽  
Yaa-Jyuhn James Meir ◽  
Lung-Kun Yeh ◽  
Hsin-Yuan Tan ◽  
Ching-Hsi Hsiao ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Penetrating Keratoplasty ◽  
Unusual Case ◽  
Corneal Ulcer ◽  
Amniotic Membrane Transplantation ◽  
Streptococcus Mitis ◽  
Continuous Administration ◽  
Case Presentation ◽  
Corneal Erosion ◽  
Corneal Scraping

Abstract Background: Streptococcus mitis (S. mitis) belongs to the viridan streptococci group which is rarely isolated as a causative pathogen of corneal ulcer. When it causes keratitis, penetrating keratoplasty (PK) might be necessary. Herein, we demonstrated amniotic membrane transplantation (AMT) can be an easier surgery with acceptable outcomes and less complication. Case presentation: A 63-year-old female Taiwanese presented with right persistent corneal ulcer for nine months. Culture from corneal scraping yielded S. mitis. A right eye descemetocele decreased from 3 mm in diameter to 0.8 mm after continuous administration of topical Vancomycin and Ceftriaxone for two weeks. Due to retarded healing, AMT was performed. Her corneal erosion healed and became clear gradually. Her visual acuity recovered from counting fingers initially to 20/200 finally 17 months after AMT. Conclusion: This unusual case illustrated that antibiotics plus AMT instead of PK may be an effective alternative treatment to promote epithelialization and reduce inflammation in corneas complicated by S. mitis keratitis.

scholarly journals Case Series of Perforated Keratomycosis after Laser-Assisted In Situ Keratomileusis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Taher Eleiwa ◽  
Eyup Ozcan ◽  
Samar Abdelrahman ◽  
Omar Solyman ◽  
Abdelrahman M. Elhusseiny ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Amniotic Membrane ◽  
Symptom Onset ◽  
Complete Resolution ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Amniotic Membrane Transplantation ◽  
Corneal Perforation ◽  
The Mean

Background. Fungal keratitis is an extremely rare complication of laser vision correction resulting in poor visual outcomes. Amniotic membrane transplantation should be kept in mind in eyes with corneal perforation prior to penetrating keratoplasty. Aim. To assess the outcomes of multilayered fresh amniotic membrane transplantation (MLF-AMT) in patients with severe keratomycosis after laser-assisted in situ keratomileusis (LASIK). Study design. Hospital-based prospective interventional case series. Methods. Five eyes of 5 patients were included in the study. All cases underwent microbiological scrapings from residual bed and intrastromal injections of amphotericin (50 mcg/mL), with flap amputation if needed, followed by topical 5% natamycin and 0.15% amphotericin. MLF-AMT was performed after corneal perforation. Later, penetrating keratoplasty (PK) was performed when corneal opacity compromised visual acuity. The outcome measures were complete resolution of infection, corneal graft survival, and best-corrected visual acuity (BCVA). Results. The mean age of patients was 22±1.2 years with 4/5 (80%) were females. The mean interval between LASIK and symptom onset was 8.8±1 day, and the mean interval between symptom onset and referral was 14±1.4 days. Potassium hydroxide (KOH) smears showed filamentous fungi, and Sabouraud’s medium grew Aspergillus in all cases. Melted flaps were amputated in 4 (80%) cases. MLF-AMT was performed in all cases due to corneal perforation after a mean time of 12.4±1.2 days of antifungals. In all cases, complete resolution of infection was seen 26±1.8 days after MLF-AMT, and optical PK was done at a mean of 2.4 months later. No postoperative complications after MLF-AMT or PK were observed, with a 0% incidence of corneal graft rejection, and a final BCVA ranged from 20/20 to 20/80 after a mean follow-up of 14±1.1 months. Conclusion. MLF-AMT is a safe and valid option to manage corneal perforation during keratmycosis treatment to avoid emergency therapeutic keratoplasty.

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