scholarly journals Use of amniotic membrane and autologous serum eye drops in Mooren’s ulcer

2013 ◽  
Vol 5 (1) ◽  
pp. 120-123 ◽  
Author(s):  
P Lavaju ◽  
M Sharma ◽  
A Sharma ◽  
S Chettri
Keyword(s):  
Amniotic Membrane ◽  
Autologous Serum ◽  
Amniotic Membrane Transplantation ◽  
Topical Steroids ◽  
Eye Drops ◽  
Cyanoacrylate Glue ◽  
Mooren’S Ulcer ◽  
The Right ◽  
Mooren's Ulcer ◽  
Serum Eye Drops

Introduction: The management of Mooren’s ulcer can be a challenge for clinicians. Objective: To report a case of Mooren’s ulcer treated with amniotic membrane transplantation supplemented with autologous serum eye drops. Case report: A 22-year-old male presented with history of pain, redness, watering and diminution of vision of the right eye for one year. Examination of his eyes revealed the best corrected visual acuity ( BCVA) of 6\60 and 6\6 in his right and left eyes respectively. Slit -lamp examination of the right eye showed a peripheral ulcer extending from 2’0 to 11’0 clock positions with peripheral thinning and the features suggestive of Mooren’s ulcer. The condition did not improve with topical steroids and cyclosporine A eye drops. Therefore, 360 degree conjunctival peritomy with cauterization of the base was performed. Since there was no obvious improvement, the amniotic membrane transplantation was done with supplementation of autologous serum eye drops 20% four times a day. The patient showed symptomatic improvement in a week. There was cessation of the progression of the ulcer and decreased vascularization. One month later, a small corneal perforation was noted and was managed well with cyanoacrylate glue and bandage contact lens application. At nine months of follow up, the patient was symptomatically better, the ulcer had healed, the vascularization had decreased and the anterior chamber was well formed. Conclusion: Amniotic membrane transplantation showed to be promising in treatment of Mooren’s ulcer refractory to immunosuppressive therapy. Addition of autologous serum eye drops seems to be an effective supplementary therapy. Nepal J Ophthalmol 2013; 5(9):120-123 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7839

Amniotic Membrane Transplantation Associated with Conjunctival Peritomy in the Management of Mooren's Ulcer: A Case Report

2005 ◽  
Vol 15 (2) ◽  
pp. 274-276 ◽  
Author(s):  
A. Lambiase ◽  
M. Sacchetti ◽  
R. Sgrulletta ◽  
M. Coassin ◽  
S. Bonini
Keyword(s):  
Amniotic Membrane ◽  
Signs And Symptoms ◽  
Central Hole ◽  
Amniotic Membrane Transplantation ◽  
Corneal Perforation ◽  
Mooren’S Ulcer ◽  
Progression Of Disease ◽  
The Right ◽  
Corneal Infiltrates ◽  
Mooren's Ulcer

Purpose To report the association of conjunctival peritomy with amniotic membrane transplantation (AMT) at the limbus with the exclusion of the central cornea in order to preserve visual function in one case of bilateral Mooren's ulcer. Methods A 36-year-old man with bilateral Mooren's ulcer was unresponsive to conventional therapy. Surgical procedure was performed on his right eye, at impending risk of corneal perforation. A 20 × 20 mm piece of amniotic membrane (AM) was prepared by performing a central hole of 7.5 mm diameter with a manual trephine. A 360° conjunctival peritomy was performed and the AM was placed with the epithelium side facing up and the central hole was sutured on the paracentral cornea. Results Two weeks after surgery, while the right eye showed improvement of signs and symptoms and unchanged best-corrected visual acuity (BCVA), the left eye showed a peripheral corneal perforation with prolapsed iris that required conjunctival flap. At 7 months of follow-up, the right eye showed no ocular inflammation, a reduction of the lipid-like peripheral corneal infiltrates, an increased stromal thickness, and an unchanged BCVA. The progression of corneal thinning in the left eye led the authors to perform AMT (as described) in the left eye as well. Five months after the AMT in the left eye, neither eye shows signs of disease progression, and neither requires further therapy. Conclusions Conjunctival peritomy associated with AMT may be an alternative surgical approach in the management of Mooren's ulcers to control the inflammation and the progression of disease.

scholarly journals Cryopreserved Amniotic Membrane, Autologous Serum Eye Drops, and Tea-Tree Oil Lid Scrubs in combination for the treatment of Keratoconjunctivitis in a Staphylococcus Hypersensitive Teenager

2017 ◽  
Vol 1 (1) ◽  
pp. e1-e10
Author(s):  
Tracy Doll
Keyword(s):  
Case Report ◽  
Maintenance Therapy ◽  
Meibomian Gland ◽  
Autologous Serum ◽  
Eye Drops ◽  
Tea Tree Oil ◽  
Tea Tree ◽  
Time Period ◽  
The Right ◽  
Serum Eye Drops

Abstract Background and Objective: The purpose is to present an interventional case report detailing recurrent bilateral keratoconjunctivitis secondary to Staphylococcus hypersensitivity in a teenage female. At least three times yearly, for five years, the patient has experienced episodes of severe bilateral catarrhal infiltrative or phlyctenular keratoconjunctivitis.  Comprehensive corneal and conjunctival cultures had been historically performed, twice, yielding only growth of Staphylococcus aureus and epidermidis. Prior short-term treatment regimens of topical steroids and antibiotics had not prevented recurrences. Methods: This is an interventional case report: In this patient, placement of a topical cryopreserved amniotic membrane, Prokera Slim (PKS by BioTissue), after one week of topical steroid treatment (Durezol (difluroprednate 0.05%) qid) in the right eye (OD) is compared to a steroid (difluroprednate 0.05%) taper in the left eye (OS) over an approximate one-month time period. Both eyes then continue chronic, long-term maintenance therapy with autologous serum eye drops (ASED) dosed six times daily and tea tree oil containing lids scrubs (SteriLid Foam by TheraTears) two times daily, until the present time. Supportive meibomian gland expression for meibomian gland dysfunction was also performed at the three month treatment mark. Results: The PKS treatment in the right eye resulted in superior visual acuity and ocular comfort when compared to a steroid taper in the left eye over an approximate one-month time period. These results were maintained in the left eye at the 12 month- time frame. The right eye experienced a recurrence when the patient self-discontinued all therapy in both eyes at the 4 month mark. With re-initiation of maintenance therapy of ASED and tea tree oil containing lids scrubs, she has remained symptom-free for over eight months in the right eye.  Conclusions: Further comparison and study of the treatment modalities above could result in a potentially faster, safer, and superior treatment and prevention protocol for topical ocular inflammation in Staphylococcus hypersensitive keratoconjunctivitis, particularly in pediatric populations.  

Bilateral Boston keratoprosthesis type 1 in a case of severe Mooren’s ulcer

2020 ◽  
pp. 112067212090976
Author(s):  
Marta Jerez-Peña ◽  
Borja Salvador-Culla ◽  
María F de la Paz ◽  
Rafael I Barraquer
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Penetrating Keratoplasty ◽  
Hand Movement ◽  
Amniotic Membrane Transplantation ◽  
Eye Drops ◽  
Boston Keratoprosthesis ◽  
Mooren’S Ulcer ◽  
Mooren's Ulcer

Introduction: Mooren’s ulcer is a painful, inflammatory chronic keratitis that affects corneal periphery, progressing centripetally, ultimately ending in perforation. The first line of treatment includes systemic immunomodulators, with surgery being the last option. We present a case of bilateral Boston keratoprosthesis implantation for severe Mooren’s ulcer that responded differently in each eye. Clinical case: A 32-year-old male with corneal opacification, anterior staphylomas, vision of hand movement, was started on systemic immunosuppression with cyclosporine. After two failed penetrating keratoplasties in each eye, high intraocular pressure despite diode cyclophotocoagulation, and cystic macular edema, we performed Boston keratoprosthesis type 1 in both eyes. The right eye responded initially well, with a best-corrected visual acuity of 20/80 and normal intraocular pressure. The left eye presented high intraocular pressure, which required cyclophotocoagulation, ultimately resulting in hypotony. Boston keratoprosthesis was performed but had peripheral corneal necrosis that progressed despite amniotic membrane transplantation and aggressive intensive treatment with medroxyprogesterone, autologous platelet-rich-in-growth-factors eye drops, and oral doxycycline. Thus, replacement of the semi-exposed Boston keratoprosthesis with tectonic penetrating keratoplasty was necessary. However, both eyes developed phthisis bulbi with final visual acuity of perception of light with poor localization. Conclusion: Mainstay treatment of Mooren’s ulcer is systemic immunomodulation. Surgical treatment must be considered only when risk of perforation, preferably with inflammation under control. Penetrating keratoplasty frequently fails, and Boston keratoprosthesis may be a viable option. However, postoperative complications, especially uncontrolled high intraocular pressure, corneal necrosis, and recurrence of Mooren’s ulcer may jeopardize the outcomes and need to be addressed promptly with intensive topical and systemic treatment.

scholarly journals Autologous serum eye drops for dry eye

2013 ◽  
Author(s):  
Qing Pan ◽  
Adla Angelina ◽  
Andrea Zambrano ◽  
Michael Marrone ◽  
Walter J Stark ◽  
...  
Keyword(s):  
Dry Eye ◽  
Autologous Serum ◽  
Eye Drops ◽  
Serum Eye Drops

Treatment of persistent epithelial defects with single-dose autologous serum eye drops

2021 ◽  
pp. 112067212110483
Author(s):  
Selma Özbek-Uzman ◽  
Züleyha Yalnız-Akkaya ◽  
Evin Şingar Özdemir ◽  
Ayşe Burcu
Keyword(s):  
Single Dose ◽  
Healing Time ◽  
Autologous Serum ◽  
Eye Drops ◽  
Artificial Tears ◽  
Duration Of Treatment ◽  
The Mean ◽  
Preservative Free ◽  
Serum Eye Drops

Purpose: We aimed to investigate the efficacy and safety of single-dose autologous serum eye drops (ASEDs) for treatment of persistent corneal epithelial defects (PEDs). Methods: About 34 eyes of 26 patients treated from March 2016 to May 2020 with a single dose of ASEDs for PEDs that did not respond to conventional treatment were retrospectively evaluated. Patient demographics, predisposing factors, size, and duration of the PED, duration of treatment, and dosage of ASEDs, PED healing time, success rate of the ASED treatment, and follow-up time after the onset of ASED treatment were recorded. Autologous serum eye drops (20%) were prepared by diluting the serum with preservative-free artificial tears in single-dose vials. Vials were stored at −20°C and used daily after dissolving. Results: The mean patient age was 47.0 ± 18.5 years, and 13 (50%) of the patients were male. The most common indication for ASEDs was PED after keratoplasty. The mean duration of ASED treatment was 8.5 ± 6.3 months, and mean follow-up time was 22.8 ± 12.2 months. Autologous serum eye drop treatment was effective in 25 (73.5%) eyes and partially effective in 5 (14.7%) eyes. None of the eyes displayed complications related to the treatment. Conclusion: In patients with PED for whom conservative treatment is insufficient, ASEDs prepared by dilution with preservative-free artificial tears in single-dose vials and administered based on the daily use principle appear to be effective and safe.

Effect of Autologous Serum Eye Drops on Corneal Haze After Corneal Crosslinking

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Ana M. Roldan ◽  
Sofia De Arrigunaga ◽  
Joseph B. Ciolino
Keyword(s):  
Autologous Serum ◽  
Eye Drops ◽  
Corneal Crosslinking ◽  
Corneal Haze ◽  
Serum Eye Drops
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