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Amniotic membrane transplantation in severe bacterial keratitis.
Cornea. 2007 Jan; 26(1):27-33.C

Abstract

PURPOSE

To determine whether a combination of early amniotic membrane transplantation (AMT) and early topical corticosteroid treatment could be a safe adjuvant therapy during antibacterial treatment in severe bacterial keratitis (BK) for relieving pain, avoiding iatrogenic epithelial toxicity, and allowing earlier use of topical steroids.

METHODS

In a prospective noncomparative case series, 12 patients with severe microscopically-proven BK were treated with immediate maximal topical antibiotics followed by AMT at 48 hours (single-layer epithelial side-down or multilayer epithelial side-up), plus topical steroid treatment at 72 hours. Pain relief (NRS-11 numeric rating pain scale) and the corneal epithelium healing were measured.

RESULTS

The follow-up rate was 7.5 person-months, with AMT performed once in 2 patients and twice in 10 patients with BK caused by Pseudomonas aeruginosa (5), Klebsiella pneumoniae (1), Moraxella cattharalis (1), Staphylococcus aureus (1), Staphylococcus epidermidis (2), or Streptococcus pneumoniae (1). A significant decrease in the pain score was noted from the admission day (median, 8; range, 7-10) to shortly after AMT (at day 3: median, 2; range, 1-3). Epithelial healing was achieved between 8 and 45 days (mean, 25.5 +/- 9.7 days). Neither perforation nor neovascularization was observed.

CONCLUSIONS

Early AMT combined with topical corticosteroid in severe BK provides immediate pain relief and allows epithelial healing.

Authors+Show Affiliations

Department of Ophthalmology, CHU Jean Bernard, Poitiers, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17198010

Citation

Gicquel, Jean-Jacques, et al. "Amniotic Membrane Transplantation in Severe Bacterial Keratitis." Cornea, vol. 26, no. 1, 2007, pp. 27-33.
Gicquel JJ, Bejjani RA, Ellies P, et al. Amniotic membrane transplantation in severe bacterial keratitis. Cornea. 2007;26(1):27-33.
Gicquel, J. J., Bejjani, R. A., Ellies, P., Mercié, M., & Dighiero, P. (2007). Amniotic membrane transplantation in severe bacterial keratitis. Cornea, 26(1), 27-33.
Gicquel JJ, et al. Amniotic Membrane Transplantation in Severe Bacterial Keratitis. Cornea. 2007;26(1):27-33. PubMed PMID: 17198010.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Amniotic membrane transplantation in severe bacterial keratitis. AU - Gicquel,Jean-Jacques, AU - Bejjani,Riad A, AU - Ellies,Pierre, AU - Mercié,Martial, AU - Dighiero,Paul, PY - 2007/1/2/pubmed PY - 2007/2/21/medline PY - 2007/1/2/entrez SP - 27 EP - 33 JF - Cornea JO - Cornea VL - 26 IS - 1 N2 - PURPOSE: To determine whether a combination of early amniotic membrane transplantation (AMT) and early topical corticosteroid treatment could be a safe adjuvant therapy during antibacterial treatment in severe bacterial keratitis (BK) for relieving pain, avoiding iatrogenic epithelial toxicity, and allowing earlier use of topical steroids. METHODS: In a prospective noncomparative case series, 12 patients with severe microscopically-proven BK were treated with immediate maximal topical antibiotics followed by AMT at 48 hours (single-layer epithelial side-down or multilayer epithelial side-up), plus topical steroid treatment at 72 hours. Pain relief (NRS-11 numeric rating pain scale) and the corneal epithelium healing were measured. RESULTS: The follow-up rate was 7.5 person-months, with AMT performed once in 2 patients and twice in 10 patients with BK caused by Pseudomonas aeruginosa (5), Klebsiella pneumoniae (1), Moraxella cattharalis (1), Staphylococcus aureus (1), Staphylococcus epidermidis (2), or Streptococcus pneumoniae (1). A significant decrease in the pain score was noted from the admission day (median, 8; range, 7-10) to shortly after AMT (at day 3: median, 2; range, 1-3). Epithelial healing was achieved between 8 and 45 days (mean, 25.5 +/- 9.7 days). Neither perforation nor neovascularization was observed. CONCLUSIONS: Early AMT combined with topical corticosteroid in severe BK provides immediate pain relief and allows epithelial healing. SN - 0277-3740 UR - https://www.unboundmedicine.com/medline/citation/17198010/Amniotic_membrane_transplantation_in_severe_bacterial_keratitis_ L2 - http://dx.doi.org/10.1097/ICO.0b013e31802b28df DB - PRIME DP - Unbound Medicine ER -