Effect of Amniotic Membrane Transplantation on the Healing of Bacterial Keratitis

Barequet, Irina S.; Habot‐Wilner, Zohar; Keller, Nathan; Smollan, Gill; Ziv, Hana; Belkin, Michael; Rosner, Mordechai

doi:10.1167/iovs.07-1005

Cited by 38 publications

(32 citation statements)

References 25 publications

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“…Together with appropriate antimicrobials, favorable results have been obtained in experimental necrotizing stromal keratitis caused by herpes simplex virus (HSV)-1,12,13 and by Staphylococcus aureus 7. It remains unclear whether change of antibiotics, based on the sensitivity, in such a small sample size may interfere with the interpretation of the healing effect of ProKera on the epithelial defect.…”

Section: Discussionmentioning

confidence: 99%

“…It counterbalances the epithelial toxicity of fortified antibiotic eye drops while exerting as-yet unclear antimicrobial actions5,6 and acting as a long-term drug delivery system 2. AMT can also directly promote rapid epithelialization and reduce stromal inflammation and ulceration in experimental bacterial keratitis 7. Therefore, AMT may also allow an earlier use of topical steroids, which may prevent excessive scar formation.…”

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confidence: 99%

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Sutureless Amniotic Membrane Transplantation for Severe Bacterial Keratitis

Sheha

Liang

et al. 2009

Cornea

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Purpose-To evaluate the efficacy of early sutureless amniotic membrane transplantation in the management of severe bacterial keratitis to reduce pain, inflammation, and haze, and to promote healing.Method-A noncomparative case series including 3 eyes of 3 consecutive patients with severe bacterial keratitis exhibiting persistent epithelial defect/ulcer, more than 5 mm in diameter, located within 3mm from the visual axis with infiltration occupying more than 50% of the corneal thickness. They were retrospectively reviewed following early (ie, within 96 hours) sutureless amniotic membrane transplantation via ProKera together with selective topical antibiotics and preservativefree steroid. Pain relief, inflammation, haze, and corneal epithelial healing were monitored.Results-ProKera was inserted once in 1 eye and twice in the other 2 eyes. Pain was significantly relieved and inflammation was markedly reduced in all cases. The corneal epithelial defect and stromal ulceration rapidly healed while visual acuity improved in 2 of the 3 eyes.Conclusion-Temporary sutureless amniotic membrane transplantation via ProKera allows easy insertion and replacement of the membrane in the office, as well as early intervention to promote epithelialization, reduce pain, haze and inflammation in cases with severe bacterial keratitis. This result justifies large series controlled studies in the future.Keywords amniotic membrane; bacterial keratitis; sutureless; wound healing Microbial keratitis (caused by bacteria, fungi, viruses, or parasites) is a serious ocular infection resulting in persistent epithelial defect/ulcer at the acute phase but corneal scarring and a permanent loss of vision at the chronic phase. The principal therapeutic goals for infectious keratitis are to eliminate the pathogens and to prevent irreversible corneal structural damage.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Sutureless Amniotic Membrane Transplantation for Severe Bacterial Keratitis

Sheha

Liang

et al. 2009

Cornea

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“…41 Gicquel ve ark. da şiddetli bakteriyel keratit nedeniyle erken dönemde AMT ile birlikte topikal steroid uyguladıkları olguların tamamında vaskülarizasyon gelişmeksizin epitelizasyonun tamamlandığını ve AMT sonrası ağrıda belirgin azalma olduğunu saptamışlardır.…”

Section: Discussionunclassified

Herpetik Keratit ve Bakteriyel Keratitlerde Amniyotik Membran Transplantasyonu

Yusufoğlu¹,

Burcu²,

Akkaya³

et al. 2013

Tjo

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ÖzetAmaç: Herpetik keratit (HK) ve bakteriyel keratit (BK) sonucu gelişen korneal ülserlerin tedavisinde amniyotik membran transplantasyonunun (AMT) etkinliğini değerlendirmek. Ge reç ve Yön tem: Ocak 2009-Eylül 2011 tarihleri arasında herpetik ve bakteriyel keratite bağlı korneal ülser nedeniyle AMT yapılan 46 göz (25 HK, 21 BK) prospektif olarak incelendi. Hastaların AMT öncesi görme keskinliği ve ülserin nitelikleri (derinliği, yerleşimi), AMT sonrası epitelizasyon zamanı ve sonuç görme keskinliği değerlendirildi. So nuç lar: Ortalama yaş HK'li olgularda 51,9±17,0, BK'li olgularda 53,3±22,0 yıl ve ortalama takip süresi sırasıyla 12,6±6,1 (5-33) ve 10,2±6,8 (3-27) ay idi. Ülser HK'de daha çok santral (%72,0), BK'de ise parasantral (%52,4) yerleşimliydi (p=0,030). Ülser derinliği HK'de 14 (%56,0), BK'de 7 (%33,3) olguda korneanın 1/2'sinden fazla idi (p=0,290). Herpetik keratitli olguların 8'inde daha önce geçirilmiş herpetik keratite bağlı korneal skar mevcuttu. Ortalama epitelizasyon zamanı HK'de 22,3±8,5 (12-50), BK'de 22, 1±10,9 (8-45) gün idi (p=0,488). Bakteriyel keratitli olguların tamamında AMT ile epitelizasyon sağlanırken HK'li 3 olguda 3 kez AMT'ye rağmen ülser kapanmadı ve ek cerrahiler (konjonktiva örtmesi, tektonik penetran keratoplasti) uygulandı. Her iki grupta da AMT sonrası görme keskinliğinde istatistiksel olarak anlamlı artış saptanmakla birlikte (HK; p=0,018 ve BK; p=<0,001) bu artışın BK'li olgularda daha belirgin olduğu görüldü. Tar t›fl ma: Herpetik ve bakteriyel korneal ülserlerin tedavisinde AMT etkin ve güvenilir bir yöntemdir. Herpetik gruptaki sonuç görme keskinliğinin bakteriyel gruptan daha düşük olmasının HK'de ülserin daha çok santral yerleşimli ve derin olmasından, herpetik olguların daha önce geçirdiği ataklara bağlı oluşan skarlardan kaynaklandığı düşünüldü. (Turk J Ophthalmol 2013; 43: 229-35) Anah tar Ke li me ler: Amniyotik membran trasplantasyonu, herpetik keratit, bakteriyel keratit Sum maryPur po se: To evaluate the effect of amniotic membrane transplantation (AMT) in the treatment of corneal ulcers resulting from herpetic keratitis (HK) and bacterial keratitis (BK). Ma te ri al and Met hod: Forty-six patients (25 HK, 21 BK) treated with AMT for HK or BK-related corneal ulcers between January 2009 and September 2011 were followed prospectively. The visual acuities and ulcer characteristics (depth and localization) prior to AMT and epithelialization time, as well as final visual acuities after AMT, were evaluated. Re sults: The mean age was 51.9±17.0 years in HK and 53.3±22.0 years in BK and the mean follow-up time was 12.6±6.1 (5-33) months and 10.2±6.8 (3-27) months, respectively. The ulcers were mostly central in HK (72%) and paracentral in BK (52.4%) (p=0.03). Ulcer depth was deeper than 1/2 of the cornea in 14 (56%) HK and in 7 (33.3%) BK (p=0.290). Eight HK patients had scars from previous herpetic keratitis episodes. The mean epithelialization time was 22.3±8.5 (12-50) days in days in BK (p=0.488). While epithelialization was achieved in all the patients with BK,...

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“…and associates found less corneal haze and neovascularization after using AM with antibiotic in comparison to antibiotics alone. [25]…”

Section: Amniotic Membrane Transplantationmentioning

confidence: 99%