Managing Drawbacks in Unconventional Successful Glaucoma Surgery: A Case Report of Stent Exposure

Traditional options in managing failed trabeculectomy (bleb needling, revision, additional incisional surgery and tube surgery) have a relatively high failure and complication rate. The use of microinvasive glaucoma surgery (MIGS) has generally been reserved to mild to moderate glaucoma cases, proving good safety profiles but significant limitations in terms of efficacy. We describe a patient who underwent MIGS (XEN Aquesys subconjunctival shunt implantation) after a prior failed trabeculectomy. After the surgery, the IOP was well controlled but as the stent was close to an area of scarred conjunctiva of the previous trabeculectomy, it became partially exposed. As a complete success was achieved, we decided to remove the conjunctiva over the exposed area and replace it by an amniotic membrane transplantation and a conjunctiva autograft. Six months after surgery, the unmedicated IOP is still well controlled with complete visual acuity recovery.

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Stabilization of Bilateral Progressive Rheumatoid Corneal Melt with Infliximab

Case Reports in Ophthalmological Medicine ◽

10.1155/2012/173793 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 2

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.

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Role of Amniotic Membrane Transplantation in Brittle Cornea Syndrome-A Case Report

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v8i1.57 ◽

2020 ◽

Vol 08 (01) ◽

Author(s):

Dr Prasanta Kumar Nanda ◽

Keyword(s):

Case Report ◽

Amniotic Membrane ◽

Amniotic Membrane Transplantation ◽

Brittle Cornea Syndrome

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Characteristics of New Onset Herpes Simplex Keratitis after Keratoplasty

Journal of Ophthalmology ◽

10.1155/2018/4351460 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Xiaolin Qi ◽

Miaolin Wang ◽

Xiaofeng Li ◽

Yanni Jia ◽

Suxia Li ◽

...

Keyword(s):

Visual Acuity ◽

Herpes Simplex ◽

Amniotic Membrane ◽

Antiviral Treatment ◽

Corneal Thickness ◽

Clinical Manifestations ◽

Corneal Graft ◽

Amniotic Membrane Transplantation ◽

Herpes Simplex Keratitis ◽

New Onset

Purpose. To observe clinical characteristics and treatment outcomes of new onset herpes simplex keratitis (HSK) after keratoplasty. Methods. Among 1,443 patients (1,443 eyes) who underwent keratoplasty (excluding cases of primary HSK) in Shandong Eye Hospital, 17 patients suffered postoperative HSK. The clinical manifestations, treatment regimens, and prognoses of the patients were evaluated. Results. The incidence of new onset HSK after keratoplasty was 1.18%. Epithelial HSK occurred in 10 eyes, with dendritic epithelial infiltration in 6 eyes and map-like epithelial defects in 4 eyes. Nine eyes had lesions at the junction of the graft and recipient. Stromal necrotic and endothelial HSK occurred in 7 eyes, presenting map-shaped ulcers in the entire corneal graft and recipient (two eyes) or at the graft-recipient junction (five eyes). Confocal microscopy revealed infiltration of a large number of dendritic cells at the junction of the lesion and transparent cornea. All 10 eyes with epithelial lesions and two eyes suffering stromal lesions of ≤1/3 corneal thickness healed after systematic and local antiviral treatment. Best-corrected visual acuity and corneal graft transparency were restored. For stromal HSK with an ulcer of >1/3 corneal thickness, amniotic membrane transplantation was performed, and visual acuity and graft transparency decreased significantly. Conclusion. New onset HSK after keratoplasty primarily resulted in epithelial and stromal lesion, involving both the graft and recipient. Effective treatments included antiviral medications and amniotic membrane transplantation. Delayed treatment may lead to aggravated graft opacification.

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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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Successful treatment of acute ocular involvement in Stevens–Johnson syndrome with amniotic membrane transplantation: a case report

Canadian Journal of Ophthalmology ◽

10.1016/j.jcjo.2012.04.016 ◽

2012 ◽

Vol 47 (6) ◽

pp. e44-e46 ◽

Cited By ~ 5

Author(s):

Tiiu M. Hess ◽

Hall F. Chew

Keyword(s):

Case Report ◽

Amniotic Membrane ◽

Successful Treatment ◽

Stevens Johnson Syndrome ◽

Amniotic Membrane Transplantation ◽

Ocular Involvement ◽

Johnson Syndrome

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Amniotic membrane transplantation for wound dehiscence after deep lamellar keratoplasty: a case report

Journal of Medical Case Reports ◽

10.1186/1752-1947-1-28 ◽

2007 ◽

Vol 1 (1) ◽

Cited By ~ 2

Author(s):

Tetsuya Kawakita ◽

Tamaki Sumi ◽

Murat Dogru ◽

Kazuo Tsubota ◽

Jun Shimazaki

Keyword(s):

Case Report ◽

Amniotic Membrane ◽

Wound Dehiscence ◽

Lamellar Keratoplasty ◽

Amniotic Membrane Transplantation ◽

Deep Lamellar Keratoplasty

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Visual Acuity and Number of Amniotic Membrane Layers as Indicators of Efficacy in Amniotic Membrane Transplantation for Corneal Ulcers: A Multicenter Study

Journal of Clinical Medicine ◽

10.3390/jcm10153234 ◽

2021 ◽

Vol 10 (15) ◽

pp. 3234

Author(s):

Javier Lacorzana ◽

Antonio Campos ◽

Marina Brocal-Sánchez ◽

Juan Marín-Nieto ◽

Oswaldo Durán-Carrasco ◽

...

Keyword(s):

Visual Acuity ◽

Success Rate ◽

Amniotic Membrane ◽

Multicenter Study ◽

Amniotic Membrane Transplantation ◽

Entire Cohort ◽

Corneal Ulcers ◽

Eyelid Malposition ◽

Retrospective Multicenter Study ◽

Better Than

Background: To evaluate new indicators in the efficacy of amniotic membrane transplantation (AMT) for non-healing corneal ulcers (NHCUs). Methods: Retrospective, multicenter study. In total, 223 AMTs for NHCU in 191 patients were assessed. The main outcomes studied were the success rate of AMT (complete re-epithelization), postoperative visual acuity (VA) gain, and number of AM layers transplanted. Results: The overall AMT success rate was 74.4%. In 92% of our patients VA stability or improvement. Postoperative VA was significantly higher than preoperative VA in the entire cohort (p < 0.001) and in all etiological groups of ulcers (post-bacterial, p ≤ 0.001; post-herpetic, p ≤ 0.0038; neurotrophic ulcers, p ≤ 0.014; non-rheumatic peripheral, p ≤ 0.001; and ulcers secondary to lagophthalmos and eyelid malposition or trauma, p ≤ 0.004). Most participants (56.5%) presented a preoperative VA equal to or less than counting fingers (≤0.01). Of these, 13.5% reached a postoperative VA equal to or better than legal blindness (≥0.05) after AMT. A higher success rate was observed in the monolayer than in the multilayer AMT (79.5% and 64.9%, respectively; p = 0.018). No statistically significant values were found between the number of layers transplanted and VA gain (p = 0.509). Conclusion: AMT is not only beneficial in achieving complete re-epithelialization in NHCUs but also in improving postoperative VA; these improvements are independent of etiologies of ulcers. Furthermore, the use of monolayer AMT seems to be a more appropriate option than multilayer AMT for NHCU since the multilayer AMT did not present better outcomes (success rate and VA gain) compared to monolayer AMT in the different types of ulcers studied.

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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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OUTCOMES OF PRIMARY PTERYGIUM EXCISION WITH AMNIOTIC MEMBRANE TRANSPLANTATION

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.2.16 ◽

2011 ◽

pp. 118-122

Author(s):

Van Nam Phan ◽

Thanh Hai Nguyen ◽

Nhu Vinh Tuyen Pham

Keyword(s):

Visual Acuity ◽

Prospective Study ◽

Key Words ◽

Amniotic Membrane ◽

Clinical Case ◽

Amniotic Membrane Transplantation ◽

Clinical Case Study ◽

Pterygium Excision ◽

Primary Pterygium

The study of primary pterygium excision with amniotic membrane transplantation contribute to the treament of pterygium. Objectives: To evaluate the outcome of primary pterygium excision with amniotic membrane transplantation. Methods: prospective study, clinical case study with no control. Results: 69,44% patients with primary pterygia were mainly at the age 20 to 60 years. Pterygia at level III were 71,15%. After surgery visual acuity was not remarkably increased while astigmation was reduced remarkably. Good result was 93,67%. Recurrent rate at 3 months after surgery was 2,08%. Conclusion: Pterygium excision with amniotic membrane transplantation has many benefits like highly cosmetic, meet the patient’s demand and saving conjuntiva. This method has the same recurrent rate compare wih other methods. Key words: pterygium, amniotic membrane, recurrent, conjuntiva, transplantation.

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