Abordagem desafiante de uma úlcera de córnea neurotrófica e por exposição

Neves, Miguel Mesquita; Oliveira, Luís; Carneiro, Ines Soares; Gomes, Miguel

doi:10.5935/0034-7280.20190127

Cited by 1 publication

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The long posterior ciliary nerves densely innervate the cornea and play a crucial role in maintaining epithelial integrity. Damage to this innervation compromises the protective reflex, reduces the number of stem cells and their metabolism, and disrupts, or decreases cellular mitoses (1,2) , thereby leading to a spectrum of visionthreatening corneal complications.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Amniotic membrane transplantation for neurotrophic corneal ulcers

Linhares,

Martinelli,

Ghem

et al. 2024

ABO

View full text Add to dashboard Cite

To evaluate the clinical results of cryopreserved amniotic membrane transplantation as a treatment option for refractory neurotrophic corneal ulcers. Methods: This prospective study included 11 eyes of 11 patients who underwent amniotic membrane transplantation for the treatment of refractory neurotrophic corneal ulcers at Hospital de Clínicas da Universidade Federal do Paraná, in the city of Curitiba, from May 2015 to July 2021. Patients underwent different surgical techniques in which the amniotic membrane was applied with the epithelium facing upward to promote corneal re-epithelialization. Results: The median age of the patients was 60 years (range, 34-82 years), and 64% were men. The predominant etiology of corneal ulcers was herpes zoster (45% of cases). Approximately one-third of the patients (27%) were chronically using hypotensive eye drops, and more than half (54%) had previously undergone penetrating corneal transplantation. At the time of amniotic membrane transplantation, 18% of the eyes had corneal melting, 9% had corneal perforation, and the others had corneal ulceration without other associated complications (73%). The time between clinical diagnosis and surgical treatment ranged from 9 days to 2 years. The corrected visual acuity was worse than 20/400 in 90% of the patients preoperatively, with improvement in 36% after 3 months of the procedure, worsening in 18% and remaining stable in 36%. Of the patients, 81% complained of preoperative pain, and 66% of them reported total symptom relief after the surgical procedure. In one month, 54.6% of the patients presented a closure of epithelial defect, and half of the total group evolved with corneal thinning. The failure rate was 45.5% of the cases. Conclusion: Cryopreserved amniotic membrane transplantation can be considered a good alternative for treating refractory neurotrophic corneal ulcers, as it resulted in significant improvement in pain (66%) and complete epithelial closure (60%) in many patients at 1 month postoperatively. Notably, the high failure rate highlights the need for further studies to identify patient-and ulcer-related factors that may influence the outcomes of this procedure.

show abstract

Section: Introductionmentioning

confidence: 99%

“…This structure has several properties, such as antiadhesiveness, bacteriostaticity, injury protection, pain reduction, and epithelialization effect, besides having little antigenicity. AM transplantation is a promising treatment for corneal ulcers (1) .…”

Section: Introductionmentioning

confidence: 99%