Simultaneous amniotic membrane transplantation in emergency penetrating keratoplasty: a therapeutic option for severe corneal ulcerations and melting disorders

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.

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Amniotic Membrane Transplantation for the Treatment of Infectious Ulcerative Keratitis Before Elective Penetrating Keratoplasty

Cornea ◽

10.1097/ico.0b013e318298de10 ◽

2013 ◽

Vol 32 (10) ◽

pp. 1321-1325 ◽

Cited By ~ 17

Author(s):

Stephan Hoffmann ◽

Norá Szentmáry ◽

Berthold Seitz

Keyword(s):

Amniotic Membrane ◽

Penetrating Keratoplasty ◽

Amniotic Membrane Transplantation ◽

Ulcerative Keratitis

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Evaluation of Plasma-Assisted Noninvasive Surgery (PANIS) as a New Technique for Sublimating Large Benign Conjunctival Nevus with Amniotic Membrane Transplantation (AMT); A Clinical Case Report

10.21203/rs.3.rs-1110209/v1 ◽

2021 ◽

Author(s):

Farhad Nejat ◽

Khosrow Jadidi ◽

Shima Eghtedari ◽

Maryam Moradi ◽

Nazanin Sadat Nabavi

Keyword(s):

Case Report ◽

Amniotic Membrane ◽

Therapeutic Option ◽

Amniotic Membrane Transplantation ◽

Surgical Removal ◽

Ocular Surface Disease Index ◽

Noninvasive Surgery ◽

Ocular Lesions ◽

History Of ◽

A New Technique

Abstract Background: conjunctival nevi are benign ocular lesions with a low risk of malignant transformation to melanoma. Due to cosmetic reasons patients usually consider surgical removal options. In this case report, we are presenting a new approach using plasma-assisted noninvasive surgery (PANIS) with amniotic membrane transplantation (AMT) to sublimate the nevus border and fuse the AMT with the remaining conjunctiva.Case presentation: A 33-year-old man with a history of large conjunctival nevus in his left eye, that its benignity was proved by an expert ophthalmologist through years of examination, has visited our center in September 2020. Plasma spots were used to sublimate the nevus border and fuse AMT with the conjunctiva. The patient was discharged fully satisfied without any complications and no recurrences were seen in a year of follow-up. Visual parameters were not significantly changed while the Ocular Surface Disease Index (OSDI) was reduced dramatically. Conclusion: Conjunctival nevi removal using the PANIS method with AMT is a safe, minimally invasive, and inexpensive therapeutic option. Plasma spots are suitable for AMT adhesion to the remaining conjunctiva after the nevus removal.

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

Eye ◽

10.1038/eye.2008.140 ◽

2008 ◽

Vol 23 (4) ◽

pp. 840-848 ◽

Cited By ~ 19

Author(s):

B Seitz ◽

S Das ◽

R Sauer ◽

D Mena ◽

C Hofmann-Rummelt

Keyword(s):

Amniotic Membrane ◽

Penetrating Keratoplasty ◽

Amniotic Membrane Transplantation ◽

Corneal Epithelial

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

10.21203/rs.2.434/v1 ◽

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.

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

Case Reports in Ophthalmological Medicine ◽

10.1155/2020/7237903 ◽

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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