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Combined anterior chamber washout, amniotic membrane transplantation, and topical use of corticosteroids for severe peripheral ulcerative keratitis.
Cornea. 2014 Jun; 33(6):559-64.C

Abstract

PURPOSE

The aim of this study was to evaluate the efficacy of anterior chamber washout, amniotic membrane transplantation, and topical use of corticosteroids in the treatment of severe peripheral ulcerative keratitis with membranous endothelial exudation.

METHODS

Twelve patients (12 eyes) with severe corneal ulceration were included. All ulcers were located at the corneal periphery, accompanied by central corneal epithelial defects and stromal edema. Membranous endothelial exudates were observed by anterior segment optical coherence tomography. The duration of the ulcers was 1 to 10 months (mean, 3.0 ± 2.9 months) before the patients visited our institution. Corneal inflammation and ulceration could not be controlled after 2 weeks of topical antiinflammation treatment. Bacterial, fungal, and Acanthamoeba infections were not detected. Surgical treatment was performed. After the necrotic corneal tissue was cut, exudation clinging to the endothelium was removed. Then, amniotic membrane was placed on the corneal lesion. Postoperatively, corticosteroid eye drops and topical and systemic antiinflammation medication were given. Healing of corneal ulcers and improvement of stromal edema were detected by slit-lamp microscopy. All patients were followed up for 3 to 15 months (mean, 6.5 ± 3.7 months).

RESULTS

All corneal ulcers healed by 1 to 2 weeks after surgery. The corneal stromal edema subsided within 1 month. All patients achieved a stable ocular surface. There was no recurrence during the follow-up.

CONCLUSIONS

Anterior chamber washout and amniotic membrane transplantation combined with topical corticosteroids seems to be effective for the treatment of severe peripheral ulcerative keratitis with endothelial exudates.

Authors+Show Affiliations

Shandong Eye Hospital, Shandong Eye Institute, Shandong Academy of Medical Sciences, Jinan, China.No 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

24763125

Citation

Jia, Yanni, et al. "Combined Anterior Chamber Washout, Amniotic Membrane Transplantation, and Topical Use of Corticosteroids for Severe Peripheral Ulcerative Keratitis." Cornea, vol. 33, no. 6, 2014, pp. 559-64.
Jia Y, Gao H, Li S, et al. Combined anterior chamber washout, amniotic membrane transplantation, and topical use of corticosteroids for severe peripheral ulcerative keratitis. Cornea. 2014;33(6):559-64.
Jia, Y., Gao, H., Li, S., & Shi, W. (2014). Combined anterior chamber washout, amniotic membrane transplantation, and topical use of corticosteroids for severe peripheral ulcerative keratitis. Cornea, 33(6), 559-64. https://doi.org/10.1097/ICO.0000000000000130
Jia Y, et al. Combined Anterior Chamber Washout, Amniotic Membrane Transplantation, and Topical Use of Corticosteroids for Severe Peripheral Ulcerative Keratitis. Cornea. 2014;33(6):559-64. PubMed PMID: 24763125.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combined anterior chamber washout, amniotic membrane transplantation, and topical use of corticosteroids for severe peripheral ulcerative keratitis. AU - Jia,Yanni, AU - Gao,Hua, AU - Li,Suxia, AU - Shi,Weiyun, PY - 2014/4/26/entrez PY - 2014/4/26/pubmed PY - 2014/10/30/medline SP - 559 EP - 64 JF - Cornea JO - Cornea VL - 33 IS - 6 N2 - PURPOSE: The aim of this study was to evaluate the efficacy of anterior chamber washout, amniotic membrane transplantation, and topical use of corticosteroids in the treatment of severe peripheral ulcerative keratitis with membranous endothelial exudation. METHODS: Twelve patients (12 eyes) with severe corneal ulceration were included. All ulcers were located at the corneal periphery, accompanied by central corneal epithelial defects and stromal edema. Membranous endothelial exudates were observed by anterior segment optical coherence tomography. The duration of the ulcers was 1 to 10 months (mean, 3.0 ± 2.9 months) before the patients visited our institution. Corneal inflammation and ulceration could not be controlled after 2 weeks of topical antiinflammation treatment. Bacterial, fungal, and Acanthamoeba infections were not detected. Surgical treatment was performed. After the necrotic corneal tissue was cut, exudation clinging to the endothelium was removed. Then, amniotic membrane was placed on the corneal lesion. Postoperatively, corticosteroid eye drops and topical and systemic antiinflammation medication were given. Healing of corneal ulcers and improvement of stromal edema were detected by slit-lamp microscopy. All patients were followed up for 3 to 15 months (mean, 6.5 ± 3.7 months). RESULTS: All corneal ulcers healed by 1 to 2 weeks after surgery. The corneal stromal edema subsided within 1 month. All patients achieved a stable ocular surface. There was no recurrence during the follow-up. CONCLUSIONS: Anterior chamber washout and amniotic membrane transplantation combined with topical corticosteroids seems to be effective for the treatment of severe peripheral ulcerative keratitis with endothelial exudates. SN - 1536-4798 UR - https://www.unboundmedicine.com/medline/citation/24763125/Combined_anterior_chamber_washout_amniotic_membrane_transplantation_and_topical_use_of_corticosteroids_for_severe_peripheral_ulcerative_keratitis_ L2 - http://dx.doi.org/10.1097/ICO.0000000000000130 DB - PRIME DP - Unbound Medicine ER -