scholarly journals Tectonic DSAEK for the Management of Impending Corneal Perforation

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Enrique O. Graue-Hernandez ◽  
Isaac Zuñiga-Gonzalez ◽  
Julio C. Hernandez-Camarena ◽  
Martha Jaimes ◽  
Patricia Chirinos-Saldaña ◽  
...  
Keyword(s):  
Dry Eye ◽  
Amniotic Membrane ◽  
Ocular Surface ◽  
Autologous Serum ◽  
Lamellar Keratoplasty ◽  
Corneal Perforation ◽  
Structural Support ◽  
History Of ◽  
The Right ◽  
Corneal Thinning

Purpose. To report a case of severe corneal thinning secondary to dry eye treated with a tectonic Descemet stripping automated lamellar keratoplasty (DSAEK) and amniotic membrane graft.Methods. A 72-year-old man with a history of long standing diabetes mellitus type 2 and dry eye presented with 80% corneal thinning and edema on the right eye and no signs of infectious disease, initially managed with topical unpreserved lubrication and 20% autologous serum drops. Eight weeks after, the defect advanced in size and depth until Descemetocele was formed. Thereafter, he underwent DSAEK for tectonic purposes. One month after the procedure, the posterior lamellar graft was well adhered but a 4 mm epithelial defect was still present. A multilayered amniotic membrane graft was then performed.Results. Ocular surface healed quickly and reepithelization occurred over a 2-week period. Eight months after, the ocular surface remained stable and structurally adequate.Conclusion. Tectonic DSAEK in conjunction with multilayered amniotic graft may not only provide structural support and avoid corneal perforation, but may also promote reepithelization and ocular surface healing and decrease concomitant inflammation.

scholarly journals Comparison of treatment efficacy between 100% platelet-rich plasma and 100% serum eye drops in moderate-to-severe dry eye disease: a randomised controlled trial protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e048479
Author(s):  
Passara Jongkhajornpong ◽  
Pawin Numthavaj ◽  
Thunyarat Anothaisintawee ◽  
Kaevalin Lekhanont ◽  
Gareth McKay ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Platelet Rich Plasma ◽  
Controlled Trial ◽  
Dry Eye Disease ◽  
Autologous Serum ◽  
Eye Disease ◽  
Eye Drops ◽  
Department Of Ophthalmology ◽  
Autologous Platelet

IntroductionDry eye disease (DED) is a common eye problem. Although the disease is not fatal, it substantially reduces quality of life and creates a high economic burden, especially in patients with moderate-to-severe DED. Several biological tear substitutes (eg, autologous serum (AS), autologous platelet-rich plasma (APRP) and autologous platelet lysate) could effectively improve dry eyes. However, evidence on their comparative efficacy is controversial. This study aims to compare the efficacy of 100% APRP with 100% AS eye drops in patients with moderate-to-severe DED.Methods and analysisThe study is a single-centre, double-blinded randomised, parallel, non-inferiority trial. One hundred and thirty patients with moderate-to-severe DED, aged 18–70 years will be recruited from outpatient clinic, Department of Ophthalmology, Ramathibodi Hospital, Bangkok from February 2021 to January 2023. Patients will be randomised to receive either 100% APRP or 100% AS eye drops (1:1 ratio) for 4 weeks. The primary outcomes are ocular surface disease index (OSDI) and ocular surface staining (OSS) evaluated using the Oxford scale. Secondary outcomes are fluorescein break-up time, Schirmer’s I test, meibomian gland parameters and adverse events. Other measured outcomes include best-corrected visual acuity, intraocular pressure and compliance.Ethics and disseminationThe study protocol and any supplements used in conducting this trial have been approved by the Ethics Committee of Faculty of Medicine, Ramathibodi Hospital, Mahidol University (MURA2020/1930). Informed consent will be obtained from all patients before study entry. Results will be presented in peer-reviewed journals and international conferences.Trial registration numberNCT04683796.

Inflammatory myofibroblastic tumour of the conjunctiva masquerading as ocular surface squamous neoplasia

2020 ◽  
pp. 112067212097361
Author(s):  
Manpreet Singh ◽  
Manu Saini ◽  
Debajyoti Chatterjee ◽  
Aditi Mehta ◽  
Manpreet Kaur ◽  
...  
Keyword(s):  
Amniotic Membrane ◽  
Ocular Surface ◽  
Surgical Excision ◽  
Excision Biopsy ◽  
Inflammatory Myofibroblastic Tumour ◽  
Complete Surgical Excision ◽  
Oral Steroids ◽  
Rare Site ◽  
The Right

A 63-year-male had painless, progressive, yellowish-pink, immobile conjunctival mass with prominent feeder vessels in the right eye of 1-year duration. The rest of the ophthalmic examination was unremarkable. MRI showed no extension into orbit or extraocular muscles. An excision biopsy with the amniotic membrane patch was performed. Histopathology confirmed inflammatory myofibroblastic tumour (IMT) with SMA and calponin positivity on immunohistochemistry. Complete surgical excision, amniotic membrane, and oral steroids provided long-term relief from recurrence. The conjunctiva is a rare site for IMT, and IMT should be kept in the differentials for atypical cases of ocular surface neoplasia.

scholarly journals Ocular Surface Disease in Sjögren's Syndrome: Management in a Scleral Lens Clinical Practice

2020 ◽  
Vol 4 (1) ◽  
pp. e12-e22
Author(s):  
Daddi Fadel ◽  
Melissa Barnett
Keyword(s):  
Quality Of Life ◽  
Sjögren’S Syndrome ◽  
Dry Eye ◽  
Ocular Surface ◽  
Sjögren's Syndrome ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Autologous Serum ◽  
Sjögren‘S Syndrome

Sjögren’s syndrome is a chronic, autoimmune, systemic disease characterized by lymphocytic infiltration and malfunction of the exocrine glands, primarily the lacrimal and salivary glands, resulting in predominant symptoms of dry eye and dry mouth. Sjögren’s syndrome is a highly prevalent condition and is one of the most common systemic, rheumatic, autoimmune diseases, affecting up to 1.4% of adults in the United States, second only to rheumatoid arthritis in its prevalence in North America. Primary Sjögren’s syndrome has shown to affect patients’ health-related quality-of-life due to dryness, chronic pain, depression, anxiety,physical and mental fatigue, and neuropsychiatric symptoms. Scleral lenses (SLs) have shown to be significantly beneficial in relieving symptoms and improvingquality-of-life in patients with Sjögren’s syndrome and dry eye disease. SLs may be used concurrently with the other therapies including ocular lubricants, eyelid hygiene, punctal occlusion, topical prescription medications, and autologous serum. This manuscript reviews the implication of Sjögren’s syndrome on the ocular surface and quality-of-life and describes how SLs, in combination with other treatments, may be beneficial.

scholarly journals Effect of Autologous Serum Eye Drops in Patients with Sjögren Syndrome-related Dry Eye: Clinical and In Vivo Confocal Microscopy Evaluation of the Ocular Surface

In Vivo ◽  
2016 ◽  
Vol 30 (6) ◽  
pp. 931-938 ◽  
Author(s):  
FRANCESCO SEMERARO ◽  
ELIANA FORBICE ◽  
GIUSEPPE NASCIMBENI ◽  
MARCO TAGLIETTI ◽  
VITO ROMANO ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Dry Eye ◽  
Ocular Surface ◽  
Sjögren Syndrome ◽  
Autologous Serum ◽  
Sjogren Syndrome ◽  
Eye Drops ◽  
In Vivo Confocal Microscopy ◽  
Serum Eye Drops

scholarly journals A Challenging Management of Pseudomonas Perforated Corneal Ulcer with Multilayer Amniotic Membrane Transplantation and Pericardial Patch Graft in Pediatric Patient

2021 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nabilah Afifah ◽  
Herwindo Dicky Putranto ◽  
Lely Retno Wulandari
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Amniotic Membrane ◽  
Corneal Ulcer ◽  
Definitive Treatment ◽  
Amniotic Membrane Transplantation ◽  
Pericardial Patch ◽  
Corneal Perforation ◽  
Corneal Ulcers ◽  
Patch Graft ◽  
The Right

Introduction: Pseudomonas aeruginosa (P. aeruginosa) is the leading cause of corneal ulcers in children 0 to 3 years of age compared to children in general. Case presentation: A two-months-old infant presented with whitish patches on the right eye two days before admission. A central corneal ulcer with a size of 7-mm x 7-mm accompanied by corneal thinning and melting was shown on the right cornea. It is was surrounded by greyish white creamy infiltrates. Corneal scraping showed Pseudomonas aeruginosa specimens. The cornea became perforate and crystalline lens extrusion was found at the day after intravenous ceftriaxone, levofloxacin eye drop, and cefazoline fortified eye drop administering. It might be caused by bacterial elastase and toxin which contributed to corneal damage. The patient was underwent a multilayer Amniotic Membrane Transplantation (AMT) combined with a pericardial patch graft due to corneal perforation. Two months post-AMT and pericardial patch graft the corneal perforation became entirely heal due to multilayer AMT, despite lysis of the pericardial patch graft. Corneal scar formation and reduction of vitreous opacity in ultrasound examination were shown. The patient was planned to undergo keratoplasty. Conclusions: Corneal ulcers due to Pseudomonas aeruginosa are highly destructive. The levels of infection, diagnostic, and therapeutic are still problems in pediatric patients. Lens extrusion and lysis of the pericardial patch graft are examples in this case. Keratoplasty is the definitive treatment for corneal ulcers with perforation; however, multilayer AMT combined with pericardial patch graft can be used as an alternative therapy to accelerate wound healing, reduce inflammation, and maintain the integrity of the eyeball.

scholarly journals Limbitis Secondary to Autologous Serum Eye Drops in a Patient with Atopic Keratoconjunctivitis

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Jeffrey David Welder ◽  
Pejman Bakhtiari ◽  
Ali R. Djalilian
Keyword(s):  
Dry Eye ◽  
Inflammatory Factors ◽  
Autologous Serum ◽  
Prior History ◽  
Eye Drops ◽  
African American Female ◽  
Atopic Keratoconjunctivitis ◽  
Immunological Diseases ◽  
History Of ◽  
Serum Eye Drops

Purpose. Report a case of limbitis secondary to autologous serum eye drops in a patient with atopic keratoconjunctivitis.Design. Interventional case report.Methods. A 32-year-old African American female with atopic keratoconjunctivitis (AKC) presented with chronic dry eye and diffuse punctate epithelial erosions refractory to conservative treatment. She was initially managed with cyclosporine ophthalmic 0.05% in addition to preservative-free artificial tears and olopatadine hydrochloride 0.2% for 6 months. She was later placed on autologous serum eye drops (ASEDs) and 4 weeks into treatment developed unilateral limbitis. The limbitis resolved shortly after stopping ASEDs in that eye; however, the drops were continued in the contralateral eye, which subsequently developed limbitis within 2 weeks. ASEDs were discontinued in both eyes, and the patient has remained quiet ever since.Results. Patient with a history of AKC and no prior history of limbitis developed limbitis shortly after starting ASEDs, which resolved promptly after discontinuation of therapy with no subsequent recurrence of inflammation.Conclusion. ASEDs are widely used in the treatment of complicated or treatment refractory dry eye. The potential side effects should be kept in mind when prescribing ASEDs for any patient, especially in those with underlying immunological diseases and circulating inflammatory factors.

scholarly journals Amniotic membrane transplantation (AMT) without the use of sutures/fibrin glue

2016 ◽  
Vol 7 (2) ◽  
pp. 173-177 ◽  
Author(s):  
Ajai Agrawal ◽  
V B Pratap
Keyword(s):  
Fibrin Glue ◽  
Dry Eye ◽  
Amniotic Membrane ◽  
Ocular Surface ◽  
Symptomatic Relief ◽  
Stevens Johnson Syndrome ◽  
Amniotic Membrane Transplantation ◽  
Sutureless Technique ◽  
Ocular Surface Reconstruction ◽  
Johnson Syndrome

Introduction: Amniotic membrane transplantation (AMT) has been used for a wide variety of ocular surface problems. Current techniques for the AMT involve suturing of the graft or patch over the ocular surface or use of fibrin glue.Objective: To describe a new sutureless technique of amniotic membrane transplantation (AMT) without the use of sutures/fibrin glue.Materials and methods: Amniotic membrane transplantation as overlay or patch was done in fourteen eyes of eight patients with severe dry eye due to Stevens Johnson syndrome for ocular surface reconstruction, promotion of epithelization, reduction of inflammation and symptomatic relief from dry eye. In this new technique of amniotic membrane transplantation, we mount the amniotic membrane with its epithelial side up on a conformer & place it on the ocular surface without applying any sutures.Conclusion: In all the fourteen eyes of eight patients operated at our centre, the amniotic membrane take up was satisfactory, with significant reduction of inflammation and symptomatic relief from dry eye. This is a simple, fast effective technique with surgical outcomes comparable to amniotic membrane transplantation using sutures/ fibrin glue.

scholarly journals Accelerated Restoration of Ocular Surface Health in Dry Eye Disease by Self-Retained Cryopreserved Amniotic Membrane

2016 ◽  
Vol 14 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Anny M.S. Cheng ◽  
Dandan Zhao ◽  
Rendian Chen ◽  
Han Y. Yin ◽  
Sean Tighe ◽  
...  
Keyword(s):  
Dry Eye ◽  
Amniotic Membrane ◽  
Ocular Surface ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Ocular Surface Health

scholarly journals Lamellar Keratoplasty Combined with Amniotic Membrane Transplantation for the Treatment of Corneal Perforations: A Clinical and In Vivo Confocal Microscopy Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Lan Ke ◽  
Dan Shen ◽  
Haoyu Wang ◽  
Chen Qiao ◽  
Qingyan Zeng
Keyword(s):  
Confocal Microscopy ◽  
Amniotic Membrane ◽  
Corneal Stroma ◽  
Lamellar Keratoplasty ◽  
Amniotic Membrane Transplantation ◽  
Corneal Perforation ◽  
In Vivo Confocal Microscopy ◽  
The Mean

Purpose. To evaluate the clinical and in vivo confocal microscopy outcome of lamellar keratoplasty combined with amniotic membrane transplantation for the treatment of corneal perforations. Methods. In this retrospective, noncomparative, and interventional case series, 13 eyes of 13 patients with corneal perforation were included. All eyes were treated with lamellar keratoplasty combined with amniotic membrane transplantation for corneal reconstruction. Age, underlying etiology, location, size of corneal ulcer, size of corneal perforation, hospitalization days and follow-up time, and corneal confocal microscopy were investigated. Aqueous leakage, anterior chamber formation, epithelial healing time, and visual acuity (VA) were monitored after operation. Results. The cause of corneal perforation (n = 13) was classified as infectious (n = 1) and noninfectious (n = 12). Most of the locations of corneal perforation were paracentral, and 2 of them were center. The anterior chambers were formed without aqueous leakage and other complications at postoperative day. The mean time of regained a smooth corneal surface was 7.5 ± 2.9 (ranging from 4 to 14) days. The mean hospitalization day was 13.1 ± 4.5 (ranging from 7 to 22) days. The mean follow-up time is 22.5 ± 14.5 (ranging from 4 to 43) months. The AM appeared as a high-reflective reflection in the corneal stroma after surgery about half a year and is almost transparent at about one year. Corneal stroma-derived cells were populated in the AM at about 1 month, increased at 2 months, and almost not obviously at 20 months postoperatively. The size and density of endothelial cells were stable after 1 year near the perforation site. The VA improved to varying degrees in 9 eyes, remained unchanged in 2 eyes, and decreased in 2 eyes. One eye recurrence and no side effects occurred during the follow-up time. Conclusion. Lamellar keratoplasty combined with amniotic membrane transplantation may be an alternative, safe, and effective surgical therapy in the treatment of corneal perforations in the absence of a fresh donor cornea. We recommend this surgery to treat with the size of corneal perforation of <4 mm in diameter no matter peripheral or central corneal perforation, especially who had immune-related diseases.

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