Amniotic Membrane Transplantation in Severe Bacterial Keratitis

Gicquel, Jj; Bejjani, R.A.; Ellies, Pierre; Mercie, M.; Dighiero, P.

doi:10.1097/ico.0b013e31802b28df

Cited by 52 publications

(42 citation statements)

References 30 publications

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“…Thus, it may be a good alternative to PKP in eyes requiring a corneal graft, especially in acute cases in which the graft rejection risk is high. 22 Gicquel et al 21 report the use of early AMT in combination with antibacterial and topical steroid treatment in the management of severe bacterial keratitis or corneal infectious ulceration. Amniotic membrane transplantation was effective in inducing pain relief and epithelial healing and in reducing inflammation.…”

Section: Discussionmentioning

confidence: 98%

“…20,21 Moreover, the AM can act as a long-term drug delivery system (''reservoir effect''), becoming soaked with antibiotic and steroid agents after the instillation of several eyedrops. 21 Based on this hypothesis, Kim et al 22 used an AM soaked with antiinfective agents before transplantation for the treatment of infectious ulcerative keratitis; they report successful outcomes, with complete ulcer healing and epithelial closure or decreased size of epithelial defects in all the treated cases and no recurrence of infection or superinfection of ulcerated lesions. Multilayer AMT has been effective in preventing corneal perforation in eyes in which the ulceration was deep into the corneal stroma, in promoting corneal healing, and in reducing progressive stromal melting.…”

Section: Discussionmentioning

confidence: 99%

“…19 A few studies have investigated the effectiveness of AMT in the surgical treatment of severe infectious keratitis with corneal ulceration or perforation. 12,13,[21][22][23] They show that AMT can be performed as an adjunctive surgical procedure for the management of severe bacterial keratitis, 21 infectious corneal ulcers, 22 and perforations, 13,23 promoting wound healing and reducing inflammation. Thus, it may be a good alternative to PKP in eyes requiring a corneal graft, especially in acute cases in which the graft rejection risk is high.…”

Section: Discussionmentioning

confidence: 99%

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Multilayer amniotic membrane transplantation for bacterial keratitis with corneal perforation after hyperopic photorefractive keratectomy

Nubile¹,

Carpineto²,

Lanzini³

et al. 2007

Journal of Cataract and Refractive Surgery

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We report a case of corneal infection caused by Streptococcus pneumoniae after hyperopic photorefractive keratectomy (PRK) that produced severe corneal melting, ulceration, and multiple perforations. Treatment included antibiogram-based antibiotic topical therapy and multilayer amniotic membrane transplantation (AMT) performed to seal the perforations and restore the globe integrity. Clinical and anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec) examinations documented progressive integration of the amniotic membrane tissues within the cornea, stromal and epithelial healing, and recovery of a stable and regular anterior chamber. The cornea healed with an avascular leucoma; the best corrected visual acuity was reduced to 20/200. Severe pneumococcal ulcerative perforation is a potential complication of PRK. Penetrating keratoplasty, at high risk for failure in the acute settings of an infected and inflamed eye, can be delayed until the cornea is healed. Amniotic membrane transplantation may be an alternative surgical option to achieve this goal.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Multilayer amniotic membrane transplantation for bacterial keratitis with corneal perforation after hyperopic photorefractive keratectomy

Nubile¹,

Carpineto²,

Lanzini³

et al. 2007

Journal of Cataract and Refractive Surgery

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“…In intractable infections, either gluing or suturing AM to the affected area has been shown to induce a favourable response to ongoing treatment. The exact mechanism of action of AM is unknown, but it is believed that the AM acts as a reservoir of the instilled medication and concentrates drug delivery to the site of infection [38,39] ( fig. 16 d-f).…”

Section: Surgical Options For Infective Keratitismentioning

confidence: 99%

The Ocular Surface: Functional Anatomy, Medical and Surgical Management

Dua¹,

Said²

2015

Cornea

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The ocular surface (OS) is a functional unit comprising the eyelids and blink reflexes, tear film and tear glands, the conjunctival mucus membrane and substantia propria, and the corneal epithelium and Bowman's zone. Its health is crucial for vision. The OS can be affected by a variety of degenerative, inflammatory and neoplastic diseases, as well as by trauma. Significant amongst these are dry eye disease, microbial infections and immune-mediated inflammatory disorders ranging from allergic conjunctivitis to destructive conditions such as ocular cicatricial pemphigoid and chemical burns. Several of these can lead to persistent epithelial defects with risk of perforation. Management principles include a thorough history and clinical evaluation of signs and symptoms to establish the diagnosis and determine the extent of disease. Treatment is tailored to the specific condition and ranges from lubricant drops to antimicrobial agents and anti-inflammatory drugs such as steroids and steroid-sparing agents. A variety of surgical procedures are often required both as adjunctive or primary interventions. These can be simple outpatient procedures such as punctal plugs and tarsorrhaphy or complex procedures such as amniotic membrane grafts, keratoplasty and limbal stem cell transplantation. In end-stage diseases where the OS is severely compromised and dry, keratoprosthesis remains the only hope to restore some sight. The Ocular SurfaceThe term 'ocular surface' (OS) was coined by Richard Thoft [1] to include the entire mucus membrane lining from the lid margins across the posterior surfaces of the eyelids, the superior, inferior, medial and lateral fornices, the eye ball, the limbus and the corneal surface together with the tear film. As an anatomical unit, the OS includes the entire conjunctival, the limbal and corneal epithelium. However, as a functional unit, the OS includes the eyelids and their movements together with the glands that secrete the various components of the tear film. As far as the depth of the OS is concerned, different authors have been fairly liberal in limiting it to the epithelium or extending it to the entire thickness of the conjunctiva and all layers of the cornea. Functional AnatomyThe key player at the OS is the transparent cornea, which interfaces with light rays as they traverse to the retina. The other elements of the OS serve to maintain a healthy environment in which the cornea can retain its transparency and facilitate vision. Despite its very organized structure, Güell JL (ed): Cornea.

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“…20 In a group of patients with various infectious ulcers, AM promoted wound healing, reduced inflammation, and improved visual acuity in those without scarring. 21 In a recent report of patients with severe bacterial keratitis, Gicquel et al 22 reported immediate pain relief and epithelial healing that they attributed to early AM transplantation combined with topical corticosteroids.…”

mentioning

confidence: 97%

Effect of Amniotic Membrane Transplantation on the Healing of Bacterial Keratitis

Barequet¹,

Habot‐Wilner²,

Keller

et al. 2008

Invest. Ophthalmol. Vis. Sci.

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Amniotic Membrane Transplantation in Severe Bacterial Keratitis

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

Cited by 52 publications

References 30 publications

Multilayer amniotic membrane transplantation for bacterial keratitis with corneal perforation after hyperopic photorefractive keratectomy

Multilayer amniotic membrane transplantation for bacterial keratitis with corneal perforation after hyperopic photorefractive keratectomy

The Ocular Surface: Functional Anatomy, Medical and Surgical Management

Effect of Amniotic Membrane Transplantation on the Healing of Bacterial Keratitis

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