1
|
Leonhard M, Turner C, Langenbucher A, Flockerzi E, Seitz B. [Comparison of the Effect of Autologous Serum on Therapy Resistant Corneal Erosions and Ulcers on the Corneal Graft vs. the Patient's Own Cornea]. Klin Monbl Augenheilkd 2024; 241:102-109. [PMID: 37164338 DOI: 10.1055/a-2091-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
PURPOSE The aim of this study is to compare the healing of corneal epithelial defects or ulcers on the corneal graft in comparison with the patient's own cornea after treatment with 100%, undiluted autologous serum eye drops. METHODS In a retrospective study over 7 years, we analysed 263 treatments with autologous serum eye drops of persistent corneal epithelial defects (erosions [88%] vs. ulcers [12%]). We compared the epithelial healing tendency of patients with defects on their own cornea (51.9%) vs. patients who had previously undergone penetrating keratoplasty (48.1%). Complete epithelial healing during the 28 days of treatment was considered as therapeutic success. In addition, the recurrence rate of the epithelial defects after finishing the therapy was analysed. RESULTS 88.2% of the epithelial defects healed during 28 days of therapy. The recurrence rate during follow-up was 5.1%. There was no significant difference with respect to success rate between corneal defects on the patient's own cornea (87.8%) and on the graft (88.6%; p = 0.137). There was a significantly lower success rate for corneal ulcers (74.2%) than for erosions (90.3%; p < 0.001). The recurrence rate of erosions was 4.4%, vs. 4.3% in ulcers during follow-up. CONCLUSION The results of our study suggest that autologous serum eye drops are a non-invasive and safe alternative treatment for persistent corneal epithelial defects - with no significant difference in patients with a defect on their own cornea vs. defects on the corneal graft. The success rate, but not the recurrence rate, is significantly worse in ulcers than in erosions.
Collapse
Affiliation(s)
- Marie Leonhard
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Homburg/Saar, Deutschland
| | - Christina Turner
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Homburg/Saar, Deutschland
| | - Achim Langenbucher
- Institut für Experimentelle Ophthalmologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Deutschland
| | - Elias Flockerzi
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Homburg/Saar, Deutschland
| | - Berthold Seitz
- Klinik für Augenheilkunde, Universitätsklinikum des Saarlandes (UKS), Homburg/Saar, Deutschland
| |
Collapse
|
2
|
Indications and Results of Emergency Penetrating Keratoplasty With Simultaneous Cataract Surgery ("Triple-PKP à Chaud"). Cornea 2023; 42:272-279. [PMID: 35587899 DOI: 10.1097/ico.0000000000003035] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 02/17/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to analyze the indications and clinical results of emergency penetrating keratoplasty with simultaneous cataract surgery ("Triple-PKP à chaud"). METHODS This study included all subjects who underwent Triple-PKP à chaud between 2006 and 2020 at the Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar in Germany. Data obtained from patient records were retrospectively analyzed. RESULTS Triple-PKP à chaud was successfully performed in 27 of 29 eyes with a mean age of 66.0 ± 19.9 years. Previous surgery was performed in 20 eyes (69.0%), most frequently amniotic membrane transplantation in 11 eyes (37.9%) and previous keratoplasty in 9 eyes (31.0%). The most common indication was infectious keratitis (62.1%). In 27 subjects (93.1%), capsulorhexis was performed using the open-sky technique. The most frequent intraoperative complication was positive vitreous pressure (24.1%). In 2 eyes (6.9%), no intraocular lens implantation was performed because of posterior capsule rupture. The preoperative uncorrected visual acuity improved from 2.2 ± 0.6 logMAR (range = 3.0-0.7 logMAR) to 1.3 ± 0.7 logMAR (range = 3.0-0.18 logMAR) postoperatively ( P < 0.001). Common postoperative complications were suture loosening (44.4%) and corneal epithelial defects (33.3%). Repeat keratoplasty was necessary in 14 eyes (51.9%), including 9 eyes (64.2%) within 12 months postoperatively. The mean graft survival was 12.2 ± 17.9 months (range = 1-69 mo). CONCLUSIONS Triple-PKP is also feasible in emergency conditions. Nevertheless, the surgery is associated with an increased risk of intraoperative and postoperative complications. Combined surgery should, therefore, only be performed in severely diseased eyes with progressed stage of cataract.
Collapse
|
3
|
[Autologous serum eye drops for therapy-resistant epithelial defects of the cornea : Impact of underlying disease and simultaneous amniotic transplantation in 990 applications]. DIE OPHTHALMOLOGIE 2023; 120:43-51. [PMID: 35925344 DOI: 10.1007/s00347-022-01677-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND The aim of the study was to evaluate the impact of simultaneous amniotic membrane transplantation (AMT), status of the cornea (own cornea vs. graft) and underlying disease on the success and recurrence rates of autologous serum (AS) in therapy-resistant epithelial defects. PATIENTS AND METHODS Between 2007 and 2019, 990 treatments with AS in 703 eyes of 645 patients were retrospectively examined. The presence of erosion or ulcer, use of AMT, status of the cornea and the underlying disease were recorded. Epithelial closure rate within 4 weeks and the recurrence rate after epithelial closure were main outcome measures. The median observation period was 50 months. RESULTS Epithelial closure was seen in 73.6% and recurrence in 27.4%. AMT was used significantly more often for ulcers (p < 0.001) and recurrences (p = 0.048). Without AMT, there was a significantly higher epithelial closure rate (p < 0.001) and faster healing tendency (p < 0.001). There was no difference between own corneas and grafts with respect to epithelial closure rate (p = 0.47). On the grafts there was a significantly higher recurrence rate (p = 0.004) and faster recurrence (p = 0.03), especially ≤6 months after epithelial closure. The underlying diseases showed a significant difference in epithelial closure rate (p = 0.02) and recurrence rate (p < 0.001) with highest success in corneal dystrophies and lowest in congenital aniridia. CONCLUSION AS is an effective therapeutic option for therapy-resistant epithelial defects. There was a high success rate for the grafts but with a higher tendency to develop recurrences. In cases of simultaneous AMT, a reduced success rate can be expected, due to the higher complexity of the given situation. AS can be used successfully in various underlying diseases, with limitations in case of congenital aniridia.
Collapse
|
4
|
Hamon L, Daas L, Seitz B. Hornhautulkus – Handlungspfad. Klin Monbl Augenheilkd 2022. [DOI: 10.1055/a-1892-6318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
5
|
Hamon L, Daas L, Seitz B. Hornhautulkus – Handlungspfad. AUGENHEILKUNDE UP2DATE 2022. [DOI: 10.1055/a-1705-1623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
6
|
Abstract
Modern macular hole surgery results in high closure rates of over 90% and good functional results especially in macular holes up to 400 µm in diameter. The standard of care in most of these cases consists of transconjunctival sutureless pars plana vitrectomy, peeling of the inner limiting membrane (ILM) around the hole, followed by gas tamponade and positioning of the patient. As closure rates and functional results decrease with larger macular hole diameters over approximately 400 µm, alternative surgical techniques have been introduced to improve anatomical and functional results in these cases. These techniques include the positioning of tissue within the macular hole to improve hole closure. This can be performed using an ILM flap or free flap technique and the transplantation of autologous retinal tissue, lens capsule or homologous amniotic tissue in or under the defect. An alternative promising approach is the attenuation of the rim of the hole by induction of a localized retinal detachment at the posterior pole which is achieved by subretinal injection of balanced salt solution (BSS) using a 41 gauge needle. The operation is completed by an endotamponade using gas or silicone oil.
Collapse
Affiliation(s)
- Christos Haritoglou
- Augenklinik Herzog Carl Theodor, Nymphenburger Str. 43, 80335, München, Deutschland.
| | - Armin Wolf
- Augenklinik, Ludwig-Maximilians-Universität, München, Deutschland
| | - Joachim Wachtlin
- Sankt Gertrauden Krankenhaus, Berlin, Deutschland
- Medizinische Hochschule Brandenburg, Neuruppin, Deutschland
| |
Collapse
|
7
|
|
8
|
|
9
|
Suárez-Barrio C, Etxebarria J, Hernáez-Moya R, Del Val-Alonso M, Rodriguez-Astigarraga M, Urkaregi A, Freire V, Morales MC, Durán JA, Vicario M, Molina I, Herrero-Vanrell R, Andollo N. Hyaluronic Acid Combined with Serum Rich in Growth Factors in Corneal Epithelial Defects. Int J Mol Sci 2019; 20:ijms20071655. [PMID: 30987108 PMCID: PMC6480555 DOI: 10.3390/ijms20071655] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 12/30/2022] Open
Abstract
The aim of this study is to assess if an adhesive biopolymer, sodium hyaluronate (NaHA), has synergistic effects with s-PRGF (a serum derived from plasma rich in growth factors and a blood derivative that has already shown efficacy in corneal epithelial wound healing), to reduce time of healing or posology. In vitro proliferation and migration studies, both in human corneal epithelial (HCE) cells and in rabbit primary corneal epithelial (RPCE) cultures, were carried out. In addition, we performed studies of corneal wound healing in vivo in rabbits treated with s-PRGF, NaHA, or the combination of both. We performed immunohistochemistry techniques (CK3, CK15, Ki67, ß4 integrin, ZO-1, α-SMA) in rabbit corneas 7 and 30 days after a surgically induced epithelial defect. In vitro results show that the combination of NaHA and s-PRGF offers the worst proliferation rates in both HCE and RPCE cells. Addition of NaHA to s-PRGF diminishes the re-epithelializing capability of s-PRGF. In vivo, all treatments, given twice a day, showed equivalent efficacy in corneal epithelial healing. We conclude that the combined use of s-PRGF and HaNA as an adhesive biopolymer does not improve the efficacy of s-PRGF alone in the wound healing of corneal epithelial defects.
Collapse
Affiliation(s)
- Carlota Suárez-Barrio
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Jaime Etxebarria
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
- Department of Ophthalmology, University Hospital of Cruces, BioCruces Health Research Institute, Begiker, 48903 Barakaldo, Spain.
| | - Raquel Hernáez-Moya
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Marina Del Val-Alonso
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Maddalen Rodriguez-Astigarraga
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Arantza Urkaregi
- Department of Applied Mathematics and Statistics and Operational Research, BioCruces Health Research Institute, 48940 Leioa, Spain.
| | - Vanesa Freire
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
- R & D Department, Instituto Clínico-Quirúrgico de Oftalmología, 48006 Bilbao, Spain.
| | - María-Celia Morales
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Juan Antonio Durán
- R & D Department, Instituto Clínico-Quirúrgico de Oftalmología, 48006 Bilbao, Spain.
- Department of Dermatology, Otorhinolaryngology and Ophthalmology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| | - Marta Vicario
- Pharmaceutical Innovation in Ophthalmology (InnOftal) UCM Research Group 920415. Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain.
| | - Irene Molina
- Pharmaceutical Innovation in Ophthalmology (InnOftal) UCM Research Group 920415. Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain.
| | - Rocío Herrero-Vanrell
- Pharmaceutical Innovation in Ophthalmology (InnOftal) UCM Research Group 920415. Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Complutense University, 28040 Madrid, Spain.
| | - Noelia Andollo
- Department of Cell Biology and Histology, School of Medicine and Nursing, University of the Basque Country, BioCruces Health Research Institute, Begiker, 48940 Leioa, Spain.
| |
Collapse
|
10
|
|
11
|
|
12
|
Röck T, Bartz-Schmidt KU, Landenberger J, Bramkamp M, Röck D. Amniotic Membrane Transplantation in Reconstructive and Regenerative Ophthalmology. Ann Transplant 2018. [PMID: 29507278 PMCID: PMC6248296 DOI: 10.12659/aot.906856] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background The goal of this study was to investigate numbers, indications, surgical techniques, and experiences of amniotic membrane transplantation at the University Eye Hospital Tübingen over the last 16 years. Material/Methods Data from all amniotic membrane transplantations from January 2001 to December 2016 were retrospectively analyzed. Data was accessed from the electronic database and the annual reports of the Eye Bank at the University Eye Hospital Tübingen. Results A total of 771 amniotic membrane transplantations were performed between 2001 and 2016 at the University Eye Hospital Tübingen. The mean number of amniotic membrane transplantations was 48 per year (range: 7–81). Overall, the mean number of amniotic membrane transplantations more than doubled, from 31 amniotic membrane transplantations per year during the first 8-year period to 66 amniotic membrane transplantations per year during the second 8-year period (p<0.0001). The most common surgical indications for amniotic membrane transplantation were corneal ulcers and persistent corneal epithelial defects. The inlay, overlay, and sandwich technique became the favored surgical methods for various disorders of the ocular surface. Conclusions Our study showed a significant increase of amniotic membrane transplantations from 2001 to 2016. This increase is likely influenced by the introduction of different surgical amniotic membrane transplantation techniques, the rising knowledge about containing growth factors, neurotrophins and cytokines, and the demographic change with aging of the population.
Collapse
Affiliation(s)
- Tobias Röck
- Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| | | | | | - Matthias Bramkamp
- Department of General Medicine, Ruhr-University Bochum, Bochum, Germany
| | - Daniel Röck
- Centre for Ophthalmology, University of Tübingen, Tübingen, Germany
| |
Collapse
|
13
|
Etxebarria J, Sanz-Lázaro S, Hernáez-Moya R, Freire V, Durán JA, Morales MC, Andollo N. Serum from plasma rich in growth factors regenerates rabbit corneas by promoting cell proliferation, migration, differentiation, adhesion and limbal stemness. Acta Ophthalmol 2017; 95:e693-e705. [PMID: 28266180 DOI: 10.1111/aos.13371] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 11/18/2016] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate the regenerating potential and the mechanisms through which the autologous serum derived from plasma rich in growth factors (s-PRGF) favours corneal wound healing in vitro and in vivo. METHODS We compared the effect of various concentrations of s-PRGF versus fetal bovine serum (FBS) and control treatment in rabbit primary corneal epithelial and stromal cells and wounded rabbit corneas. Cell proliferation was measured using an enzymatic colorimetric assay. In vitro and in vivo wound-healing progression was assessed by image-analysis software. Migration and invasion were evaluated using transfilter assays. Histological structure was analysed in stained sections. Protein expression was evaluated by immunohistochemistry. RESULTS s-PRGF promoted the robust proliferation of epithelial cultures at any concentration, similar to FBS. Likewise, s-PRGF and FBS produced similar re-epithelialization rates in in vitro wound-healing assays. In vivo, s-PRGF treatment accelerated corneal wound healing in comparison with control treatment. This difference was significant only for 100% s-PRGF treatment in our healthy rabbit model. Histological analysis confirmed normal epithelialization in all cases. Immunohistochemistry showed a higher expression of cytokeratins 3/76 and 15, zonula occludens-1 and alpha-smooth muscle actin proteins as a function of s-PRGF concentration. Notably, keratocyte density in the anterior third of the stroma increased with increase in s-PRGF concentration, suggesting an in vivo chemotactic effect of s-PRGF on keratocytes that was further confirmed in vitro. CONCLUSION s-PRGF promotes proliferation and migration and influences limbal stemness, adhesion and fibrosis during corneal healing.
Collapse
Affiliation(s)
- Jaime Etxebarria
- Department of Cell Biology and Histology; School of Medicine and Nursing; BioCruces Health Research Institute; University of the Basque Country; Begiker; Leioa Spain
- Department of Ophthalmology; BioCruces Health Research Institute; University Hospital of Cruces; Begiker; Barakaldo Spain
| | - Sara Sanz-Lázaro
- Department of Cell Biology and Histology; School of Medicine and Nursing; BioCruces Health Research Institute; University of the Basque Country; Begiker; Leioa Spain
| | - Raquel Hernáez-Moya
- Department of Cell Biology and Histology; School of Medicine and Nursing; BioCruces Health Research Institute; University of the Basque Country; Begiker; Leioa Spain
| | - Vanesa Freire
- Department of Cell Biology and Histology; School of Medicine and Nursing; BioCruces Health Research Institute; University of the Basque Country; Begiker; Leioa Spain
- R & D Department; Instituto Clínico-Quirúrgico de Oftalmología; Bilbao Spain
| | - Juan A. Durán
- R & D Department; Instituto Clínico-Quirúrgico de Oftalmología; Bilbao Spain
- Department of Ophthalmology; School of Medicine and Nursing; BioCruces Health Research Institute; University of the Basque Country; Begiker; Leioa Spain
| | - María-Celia Morales
- Department of Cell Biology and Histology; School of Medicine and Nursing; BioCruces Health Research Institute; University of the Basque Country; Begiker; Leioa Spain
| | - Noelia Andollo
- Department of Cell Biology and Histology; School of Medicine and Nursing; BioCruces Health Research Institute; University of the Basque Country; Begiker; Leioa Spain
| |
Collapse
|
14
|
Röck T, Bartz-Schmidt KU, Röck D. Management of a neurotrophic deep corneal ulcer with amniotic membrane transplantation in a patient with functional monocular vision: A case report. Medicine (Baltimore) 2017; 96:e8997. [PMID: 29390295 PMCID: PMC5815707 DOI: 10.1097/md.0000000000008997] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
RATIONALE Amniotic membrane transplantation (AMT) has been performed therapeutically in humans for over 100 years. In recent 2 decades AMTs have been used increasingly and successfully to treat various types of ophthalmic indications. PATIENT CONCERNS An 83-year-old man was referred to our eye hospital with a refractory neurotrophic deep corneal ulcer of the left eye. DIAGNOSES The best-corrected visual acuity of the left eye was 0.5 (0.3 logMAR) and of the right eye was 0.05 (1.3 logMAR), which was caused by a central retinal vein occlusion 5 years previously. In cases of binocular vision, a large amniotic membrane patch can cover the whole cornea, including the optical axis. However, in cases with functional monocular vision, as in the case reported here, the AMT has to be performed without the involvement of the optical axis to ensure vision for the patient. Otherwise the patient would have a massively restricted view like looking through waxed paper for at least 2-4 weeks until the overlay dissolved. INTERVENTIONS For this case, an AMT using a modified sandwich technique was applied without involvement of the optic axis to ensure vision for the patient. This case report illustrates this eye's course of healing over time. OUTCOMES A reduction in the inflammation and healing of the corneal ulcer could be seen. In addition, the corneal vascularization decreased. Six months after the AMT, a slit-lamp examination revealed stable findings. The best-corrected visual acuity of the left eye had increased to 0.8 (0.1 logMAR). LESSONS To the best of our knowledge, a case report on the management of a neurotrophic deep corneal ulcer with AMT in a patient with functional monocular vision has never been undertaken before.
Collapse
|
15
|
Schilimow A, Wiechens B. Medikamentöse Oberlidptosis in der Therapie der rezidivierenden Epitheldefekte infolge neurotropher Keratopathie. Ophthalmologe 2016; 114:745-747. [DOI: 10.1007/s00347-016-0377-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
16
|
Kasparov АА, Sobkova ОI, Kasparova EА, Kasparova ЕА. [Novel approach to treatment of lagophthalmos-associated neuroparalytic keratitis]. Vestn Oftalmol 2015; 131:26-33. [PMID: 26977724 DOI: 10.17116/oftalma2015131626-33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED Aim - to develop effective treatment approaches to lagophthalmos-associated neuroparalytic keratitis. MATERIAL AND METHODS A total of 34 patients (36 eyes) with neuroparalytic keratitis were enrolled. Group 1 consisted of 20 patients (21 eyes), in whom autoconjunctivoplasty was performed in combination with eyelid surgery. Group 2 consisted of 12 lagophthalmic patients (13 eyes) with purulent corneal ulcers, who additionally underwent corneal transplantation. Group 3 included 2 patients (2 eyes) with central corneal ulcer in the only seeing eye, who received, besides other things, upper sector iridectomy intended to serve as a pupil (RU 2299048 with priority date of 15.07.2005). RESULTS In group 1, corneal re-epithelization and complete recovery was achieved in all patients within 3.00±0.69 weeks. Visual acuity (VA) has generally increased over the first year after treatment from 0.14±0.06 to 0.25±0.13 in group 1 and from 0.09±0.05 to 0.21±0.13 in group 2. In group 3, sector iridectomies also yielded an increase in VA - from 0.01 to 0.02 in one case and from 0.2 to 0.6 in the other. Autoconjunctivoplasty enabled rapid and stable re-epithelization of corneal defects in all cases. CONCLUSION One-stage corneal and eyelid surgery has been shown to be more effective in treating lagophthalmos-associated neuroparalytic keratitis than previous methods. The novel approach ensures acute symptoms of keratitis resolve and the eye is saved, moreover, it allows to maintain visual acuity and prevent recurrences in 64% and 65% of patients, respectively.
Collapse
Affiliation(s)
- А А Kasparov
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - О I Sobkova
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - Evg А Kasparova
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| | - Еl А Kasparova
- Research Institute of Eye Diseases, 11 A, B, Rossolimo St., Moscow, Russian Federation, 119021
| |
Collapse
|
17
|
[Defect covering of a perforated corneal ulcer with bovine pericardium transplant]. Ophthalmologe 2013; 111:58-60. [PMID: 23681180 DOI: 10.1007/s00347-013-2827-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
An 89-year-old patient presented in an emergency situation with a perforated corneal ulcer of neurotrophic genesis. An operative treatment with a Tutopatch® was performed. In the course of treatment a reorganization of the Tutopatch® into corneal tissue resulted and a subsequent satisfactory defect covering with maintenance of visual acuity. Tutopatch® represents a good alternative for covering perforated corneal ulcers.
Collapse
|
18
|
|
19
|
|
20
|
|
21
|
Unterlauft J, Kohlhaas M, Hofbauer I, Kasper K, Geerling G. Albumin-Augentropfen zur Behandlung von Augenoberflächenerkrankungen. Ophthalmologe 2009; 106:932-7. [DOI: 10.1007/s00347-009-2057-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
22
|
|
23
|
Langzeitergebnisse nach Keratoplastik à chaud. SPEKTRUM DER AUGENHEILKUNDE 2006. [DOI: 10.1007/bf03164668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
24
|
Abstract
The therapy of dry eye disease as a chronic problem necessitates a long-term therapeutic association between patient and ophthalmologist. The aim of therapy is to relieve symptoms and improve vision as far as possible with an acceptable level of effort on the part of the patient. Therapy of dry eye follows a staged concept including tear replacement, serum eye drops, punctum plugs, novel anti-inflammatory drugs (cyclosporin A), and surgical procedures. Interdisciplinary care, especially of patients with autoimmune disease, is recommended and is best provided in a specialized dry eye outpatient clinic with quality control.
Collapse
Affiliation(s)
- C Cursiefen
- Augenklinik mit Poliklinik, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen.
| | | | | | | |
Collapse
|