Microbial keratitis after amniotic membrane transplantation

Al-Kharashi, Soliman A; Al-Khawaja, Ahmed; Gonnah, El-Sayed; Al-Assiri, Abdullah; Al-Motowa, Saeed; Al-Towerki, Abdul-Elah; Wagoner, Michael D.

doi:10.1007/s10792-006-9000-2

Cited by 10 publications

(8 citation statements)

References 8 publications

(9 reference statements)

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“…Additionally, cryotherapy combined with antifungal agents and/or corneoscleral grafting has been used successfully in cases of fungal scleritis and keratoscleritis (13,14). Several groups have reported promising results using human amniotic membrane as an adjunct for the treatment of active microbial keratitis (15)(16)(17). In a study conducted by Chen et al in 2006, human amniotic membrane was successfully used in active cases of fungal keratitis, even in some cases in which perforation had previously occurred (18).…”

Section: Excisional Keratectomy Combined With Focal Cryotherapy and Amentioning

confidence: 99%

Excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay for recalcitrant filamentary fungal keratitis: A retrospective comparative clinical data analysis

Chen

Gao

Duncan

et al. 2016

Experimental and Therapeutic Medicine

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The aim of the present study was to investigate the efficacy of a novel surgical intervention, excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay (EKCAI), for the treatment of recalcitrant filamentary fungal keratitis. A retrospective analysis was performed of patients who underwent excisional keratectomy combined with conjunctival flap inlay (EKCFI), EKCAI or therapeutic penetrating keratoplasty (TPK) from January 2006 to January 2011. Recalcitrance was determined as being unresponsive to standard medical antifungal therapy for at ≥1 week. Outcome measures among the three intervention modalities were compared. A total of 128 patients had a follow-up of ≥1 year after the primary intervention. The success rates of interventions at 1-year follow-up were 58.33% in the EKCFI group, 88.37% in the EKCAI group and 93.44% in the TPK group (P<0.0002). The preoperative visual acuity of the three groups were similar (P=0.6458), while the postoperative best-corrected visual acuity (BCVA) of patients without recurrence was significantly different among the three groups 3 months after surgery. The best postoperative BCVA was found in the TPK group, while the worst was in the EKCFI group. In conclusion, EKCAI does not require donor cornea, is straightforward surgically, and has a favorable success rate compared with EKCFI.

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Section: Excisional Keratectomy Combined With Focal Cryotherapy and Amentioning

confidence: 99%

Excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay for recalcitrant filamentary fungal keratitis: A retrospective comparative clinical data analysis

Chen

Gao

Duncan

et al. 2016

Experimental and Therapeutic Medicine

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“…However, microbial keratitis after AM transplantation has been previously reported, at an incidence of 9.2%. 5 Notably, the incidence decreased to 1.6% when donor tissue was prepared by a commercial laboratory using the Good Tissue Banking Practices set forth by the United States Federal Drug Administration compared to tissue preparation in a research laboratory. 6 …”

Section: Discussionmentioning

confidence: 99%

Late-onset granular intra-amniotic infection following amniotic membrane transplantation

Alreshidi

Al-Swailem

2021

American Journal of Ophthalmology Case Reports

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Background The amniotic membrane (AM) is used in ocular surface reconstruction and is effective at promoting epithelialization and preventing corneal perforation in cases of acute microbial keratitis. Here, we report a case of isolated AM infection after AM transplantation for a persistent epithelial defect following tectonic penetrating keratoplasty. Case presentation A 47-year-old man with poorly controlled type 2 diabetes mellitus presented to the emergency department with a referral for perforated microbial keratitis. After ophthalmic examination, corneal scraping was performed, and corneal gluing was attempted and failed. Hence, the patient underwent tectonic penetrating keratoplasty. After keratoplasty, the patient developed a persistent epithelial defect that required AM transplantation as an overlay. Thirty days post-AM transplant, the patient presented with signs and symptoms resembling granular microbial infection of the cornea. After two days, the granular findings began dislodging from the corneal surface and were sent for culture, sensitivity, and histopathological identification. Histological analysis of the granular material indicated it to be a small piece of AM stroma infiltrated with mixed-type inflammatory cells. Corneal scraping cultures indicated Streptococcus mitis and Streptococcus oralis . Conclusion The infiltrate was localized to the basement membrane of the AM as, despite the anti-inflammatory effects of AM, it can also act as a barrier against polymorphonuclear leukocyte infiltration from the tear film and microbial invasion into the cornea.

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“…The AM has been used for the reconstruction of the conjunctiva and resulted in a good cosmetic outcome [ 18 , 19 ]. The AM has also been widely used in the reconstruction of corneal surface in several injuries such as neurotrophic ulcers [ 34 , 35 ], persistent epithelial defects, microbial keratitis [ 36 , 37 ], band keratopathy, bullous keratopathy [ 38 , 39 ] and chemical injuries [ 38 , 40 ]. Due to its properties, an AM implant was used in this 12-year-old patient with a recurrent dermoid cyst.…”

Section: Discussionmentioning

confidence: 99%

Recurrent epibulbar dermoid cyst treated with amniotic membrane implant a case report

Villalón¹,

Leal

Chávez

et al. 2018

BMC Surg

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BackgroundThe dermoid cyst considered a cystic teratoma derived from embryonic germinal epithelium is a slow-growing benign tumour. Dermoid cysts may occur in the orbital and periorbital region in paediatric patients and are often recurrent. The surgical approach depends upon the site of the lesion, superficial or deep. To our knowledge, this is the first described case of a patient with resection of dermoid cyst treated with human amniotic membrane implant and topical application of 0.02% mitomycin C.Case presentationWe present a case of a 12-year-old male with a tumour in the superotemporal region of the right eye (RE). Symptoms included decreased visual acuity (VA), burning eye, foreign body sensation, and photophobia of the affected eye. A physical examination detected blepharospasm. Ophthalmic examination of his RE, fingers count from a 1–2 m distance, showed no improvement with pinhole. Visual acuity was 20/20 on the left eye (LE). The bio-microscopic examination confirmed the presence of a tumour mass (15 mm × 12 mm) on the surface of the RE, invading the superotemporal sector. The tumour had a lobulated appearance, a shiny and vascularized surface covered by conjunctiva, a pearlescent-pink colour, a medium consistency, was renitent and painless. An ultrasound scan revealed atrophy of the pigmented retinal epithelium with scleral indentation of the RE. A computed tomography (CT) scan revealed a recurrent lesion consistent with an epibulbar dermoid cyst. Surgical excision of the lesion was performed and a human amniotic membrane (HAM) graft and topical 0.02% mitomycin C (MMC) were applied. Histopathological analysis confirmed the diagnosis of recurrent dermoid cyst.ConclusionIn this case report, we describe a case of recurrent epibulbar dermoid cyst treated with complete resection; topical MMC and HAM implant with good clinical outcome of the lesion and implant adhesion. Resection of a cyst of the ocular surface is not recommended when a large epibulbar dermoid tissue needs to be resected and no HAM graft is available.

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Microbial keratitis after amniotic membrane transplantation

Abstract: Amniotic tissue prepared in a commercial laboratory or by properly qualified eye bank personnel may be used for AMT in eyes with persistent corneal epithelial defects with minimal risk of microbial keratitis in the first postoperative month.

Cited by 10 publications

References 8 publications

Excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay for recalcitrant filamentary fungal keratitis: A retrospective comparative clinical data analysis

Excisional keratectomy combined with focal cryotherapy and amniotic membrane inlay for recalcitrant filamentary fungal keratitis: A retrospective comparative clinical data analysis

Late-onset granular intra-amniotic infection following amniotic membrane transplantation

Recurrent epibulbar dermoid cyst treated with amniotic membrane implant a case report

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