scholarly journals Characteristics of New Onset Herpes Simplex Keratitis after Keratoplasty

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
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.

Herpes Simplex Virus Keratitis in a University Tertiary Referral Centre – Clinical Features and Surgical Approaches

2021 ◽  
Author(s):  
Raul Alfaro Rangel ◽  
Sabine Lepper ◽  
Nóra Szentmáry ◽  
Achim Langenbucher ◽  
Berthold Seitz
Keyword(s):  
Visual Acuity ◽  
Herpes Simplex Virus ◽  
Herpes Simplex ◽  
Clinical Manifestations ◽  
Tertiary Referral ◽  
Main Indication ◽  
Emergency Procedures ◽  
Common Diagnosis ◽  
Simplex Virus

Abstract Purpose To assess prevalence, clinical manifestations, required keratoplasties, follow-up, and outcome in patients with Herpes Simplex Virus Keratitis (HSK) attending a University Tertiary Referral Center. Design Retrospective (12 years), descriptive, observational study. Methods A total of 817 eyes with clinical diagnosis of HSK from 779 patients were classified by the type of presentation. We gathered data on the visual acuity, refraction, IOP, and required surgical procedures. Results Stromal involvement including scars represented the most common diagnosis in our department and the main indication of penetrating keratoplasty (PKP). Epithelial keratitis (16%) presented with the best visual acuity at the first visit. Necrotizing keratitis represented 17% of the patients, 78% of whom required PKP; this group also had the worst visual acuity at first examination and was the main indication for emergency PKP. Among all eyes, 288 (35%) required PKP. A total of 230 (28%) PKPs were elective procedures and 58 (7%) PKPs were performed as emergency procedures. Two patients with quiet endothelial decompensations after recurrent HSV endotheliitis were treated with DMEK and had good visual outcomes without HSV recurrence at last follow-up. Conclusions HSK is a prevalent disease with severe consequences when not treated appropriately and on time. Even when making an accurate diagnosis, the disease can be extremely aggressive, with all the implications it brings to the patients and health system. Elective PKP had better outcomes in terms of visual acuity and clear graft percentage compared to emergency PKP.

scholarly journals Corneal hydrops: diagnosis and treatment

2020 ◽  
Vol 13 (2) ◽  
pp. 31-42
Author(s):  
Galina V. Sitnik
Keyword(s):  
Anterior Chamber ◽  
Amniotic Membrane ◽  
Pathological Condition ◽  
Corneal Thickness ◽  
Case Series ◽  
Corneal Edema ◽  
Diagnosis And Treatment ◽  
Lamellar Keratoplasty ◽  
Amniotic Membrane Transplantation ◽  
Corneal Hydrops

Acute corneal hydrops is a pathological condition which clinically presents by marked corneal edema developing due to a break in Descemets membrane. Background. To analyze the results of diagnosis and treatment in patients with acute corneal hydrops. Materials and methods. 42 patients (47 eyes) suffering from acute corneal hydrops were included in the study. This condition appeared on both eyes simultaneously or sequentially in 5 patients. Mean age was 28.7 10.1 years (from 19 to 54 years), 31 men, 11 women. In case of complications or inefficacy of medical therapy surgical procedures were performed: 10% gas (C3F8, SF6) injection into the anterior chamber, amniotic membrane transplantation, partial lamellar keratoplasty, DALK, PKP. Results. Duration of corneal ectasia before acute hydrops occurrence was 12.6 4.6 years. Disease was not diagnosed before in 11.9%. Corneal thickness varied from 692 98 m in focal hydrops to 1200 220 m in total hydrops. Area of edema, height of Descemet detachment and gap between break margins were significantly above in cases of subtotal and total hydrops compared with focal and partial hydrops (2, p 0,001). Injection of 10% gas (C3F8, SF6) in the anterior chamber allowed to significantly accelerating the resolution of this condition in cases of subtotal and total hydrops. Conclusion. Analysis of this case series showed the feasibility of a differentiated approach in the treatment of acute corneal hydrops depending on its severity.

scholarly journals Reactivation of herpes simplex keratitis following vaccination for COVID-19

2021 ◽  
Vol 14 (9) ◽  
pp. e245792
Author(s):  
James Richardson-May ◽  
Alice Rothwell ◽  
Mohammed Rashid
Keyword(s):  
Visual Acuity ◽  
Herpes Simplex ◽  
Eye Disease ◽  
Personal Health ◽  
Herpetic Stromal Keratitis ◽  
Corneal Scarring ◽  
History Of ◽  
Stromal Keratitis ◽  
Herpes Simplex Keratitis ◽  
Prompt Diagnosis

An 82-year-old man with a history of herpes simplex keratitis 40 years previously presented with recurrence, 1 day following vaccination for novel COVID-19. His condition worsened despite topical treatment with ganciclovir gel. A diagnosis of herpetic stromal keratitis was made, requiring systemic aciclovir, topical prednisolone, moxifloxacin and atropine, and oral doxycycline. He improved clinically on treatment, with some residual corneal scarring. Visual acuity improved from 6/36 corrected at presentation, to 6/24 following treatment. Clearly, public and personal health benefits from vaccination are hugely important and we would not suggest avoiding vaccination in such patients. It is, however, important for ophthalmic providers to be aware of the rare potential for reactivation of herpetic eye disease following vaccination to enable prompt diagnosis and treatment.

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

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Antonio Fea ◽  
Paola Maria Loredana Cannizzo ◽  
Giulia Consolandi ◽  
Carlo Alessandro Lavia ◽  
Giulia Pignata ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Amniotic Membrane ◽  
Complication Rate ◽  
Glaucoma Surgery ◽  
Amniotic Membrane Transplantation ◽  
Exposed Area ◽  
Shunt Implantation

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.

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

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.

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.

OUTCOMES OF PRIMARY PTERYGIUM EXCISION WITH AMNIOTIC MEMBRANE TRANSPLANTATION

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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