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Corneal Ulcer

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2. Resorbable and running suture for stable fixation of amniotic membrane multilayers: A useful modification in deep or perforating sterile corneal ulcers (PubMed)

Resorbable and running suture for stable fixation of amniotic membrane multilayers: A useful modification in deep or perforating sterile corneal ulcers To present a modified technique for secure tightening and fixing of multilayer amniotic membranes in deep or perforating corneal ulcers.The modified procedure for application and fixation of multilayer amniotic membranes is retrospectively described step by step, and the results of three patients treated with this technique were retrospectively (...) remained stable throughout the 3- to 5-month follow-up period. This modified technique represents a very useful auxiliary means of treating deep or perforating non-infectious corneal ulcers.

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2018 American journal of ophthalmology case reports

3. Changes in interleukin-6 tear concentration and clinical outcome in moderate-to-severe bacterial corneal ulcers after corneal collagen cross-linking (PubMed)

Changes in interleukin-6 tear concentration and clinical outcome in moderate-to-severe bacterial corneal ulcers after corneal collagen cross-linking We aimed to evaluate interleukin-6 (IL-6) tear concentration and clinical outcome in patients with moderate-to-severe bacterial corneal ulcers post corneal collagen cross-linking (CXL) therapy. This pre-post designed study involving 21 moderate-to-severe corneal ulcer patients who underwent CXL therapy. Patients with infectious corneal ulcer were (...) given CXL therapy as adjunctive treatment after 5d of broadspectrum antibiotic treatment. Patients with moderate to severe infectious bacterial corneal ulcers were included in this study. Tear sampling was performed before CXL therapy, using sterile Schimer paper from conjunctival inferior fornix. CXL therapy was performed in accordance with the CXL Dresden protocol. Data recording and tear sampling were then performed at day 1 and day 7 after CXL therapy. Data recording included, presence

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2018 International journal of ophthalmology

4. Severe corneal ulcer with progression to endophthalmitis and high-grade bacteremia (PubMed)

Severe corneal ulcer with progression to endophthalmitis and high-grade bacteremia Bacterial sepsis is a common consequence of many infectious processes. Here, we describe a case of a woman with a corneal ulcer who went on to develop group B streptococcal (GBS) endophthalmitis, bacteremia, and eventual loss of the eye.A previously healthy, immunocompetent, middle aged, contact lens wearing female who, after freshwater boating in her contact lenses, developed a red, painful eye. She

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2017 American journal of ophthalmology case reports

5. Epithelial basement membrane injury and regeneration modulates corneal fibrosis after pseudomonas corneal ulcers in rabbits (PubMed)

Epithelial basement membrane injury and regeneration modulates corneal fibrosis after pseudomonas corneal ulcers in rabbits The purpose of this study was to investigate whether myofibroblast-related fibrosis (scarring) after microbial keratitis was modulated by the epithelial basement membrane (EBM) injury and regeneration. Rabbits were infected with Pseudomonas aeruginosa after epithelial scrape injury and the resultant severe keratitis was treated with topical tobramycin. Corneas were (...) analyzed from one to four months after keratitis with slit lamp photos, immunohistochemistry for alpha-smooth muscle actin (α-SMA) and monocyte lineage marker CD11b, and transmission electron microscopy. At one month after keratitis, corneas had no detectible EBM lamina lucida or lamina densa, and the central stroma was packed with myofibroblasts that in some eyes extended to the posterior corneal surface with damage to Descemet's membrane and the endothelium. At one month, a nest of stromal cells

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2017 Experimental eye research

6. Efficacy and Safety of Amphotericin B with Autologous Serum for Fungal Corneal Ulcer. (PubMed)

Efficacy and Safety of Amphotericin B with Autologous Serum for Fungal Corneal Ulcer. To observe the clinical efficacy and safety of injection therapy of amphotericin B combined with autologous serum in the treatment of fungal corneal ulcer.An experimental study.Department of Ophthalmology, Jinan Second People's Hospital, Shandong Province, China, from July 2013 to June 2017.Patients diagnosed with monocular fungal corneal ulcer were divided randomly into observation group and control group, 48 (...) cases in each group. Control group was treated with amphotericin B alone. Observation group was treated with autologous serum injection on the basis of the control group treatment. The improvement time of clinical symptoms such as hypopyon, corneal ulcer, foreign body sensation and photophobia were observed in two groups. The clinical efficacy and adverse reactions were compared between the two groups.The total effective rate of the observation group was higher than that of the control group (p

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2019 Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

7. Visual impairment in fungal versus bacterial corneal ulcers four years after successful antimicrobial treatment. (PubMed)

Visual impairment in fungal versus bacterial corneal ulcers four years after successful antimicrobial treatment. To compare longitudinal visual acuity outcomes of fungal corneal ulcers with those of bacterial ulcers.Prospective cohort study SETTING: Tertiary eye hospital in South India STUDY POPULATION: 100 individuals who had been diagnosed four years prior with either fungal or bacterial keratitis and had been enrolled in one of two concurrent randomized trials, out of 152 consecutive (...) and 10 (20.0%) individuals in the bacterial group. Median BSCVA in the affected eye at the 4-year visit was similar in the fungal and bacterial groups (Snellen equivalent 20/32 for each), though vision worse than 20/400 was more common in the fungal ulcer group after spectacle correction (OR 4.19, 95%CI 1.11 to 15.8) and contact lens correction (OR 5.74, 95%CI 1.37-24.1).In this South Indian population with a previous episode of fungal or bacterial keratitis, correctable bilateral visual impairment

2019 American Journal of Ophthalmology

8. Individualized penetrating keratoplasty using edge-trimmed glycerol-preserved donor corneas for perforated corneal ulcers. (PubMed)

Individualized penetrating keratoplasty using edge-trimmed glycerol-preserved donor corneas for perforated corneal ulcers. To report a surgical technique and the surgical outcomes of individualized penetrating keratoplasty (PK) using edge-trimmed glycerol-preserved donor corneas for perforated corneal ulcers.Fourteen perforated eyes from 14 patients who underwent individualized PK using edge-trimmed glycerol-preserved donor corneas, were included in the retrospective study. The perforations (...) were mainly 1-2 mm in size except for one that was 2.5 × 4 mm. Three patients were treated with PK; one patient was treated with PK and a conjunctival flap; ten patients who had large ulcer areas were treated with PK combined with lamellar keratoplasty (LK). Donor corneas were preserved in sterile pure glycerol at - 80 °C. Corneal grafts were specially edge-trimmed to match the perforation, and then sutured onto the recipient bed avoiding the visual axis.All 14 patients recovered anatomical

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2019 BMC Ophthalmology

9. A case report of infectious scleritis with corneal ulcer caused by Scedosporium aurantiacum. (PubMed)

A case report of infectious scleritis with corneal ulcer caused by Scedosporium aurantiacum. Scedosporium species is rare pathogen of ocular infection. The accurate diagnosis is delaying in many cases and the clinical prognosis is poor due to its resistance to antifungal agents. This report describes a patient with infectious scleritis and corneal ulcer caused by Scedosporium auranticum infection who required enucleation to control the infection.A 70-year-old woman visited our clinic after (...) experiencing ocular discomfort in her right eye for 4 days after minor ocular trauma, with soil exposure.Scedosporium species was isolated from a culture of corneal tissue, Scedosporium aurantiacum was identified in a culture of necrotic tissue.She was started on treatment with antifungal agents, including topical amphotericin B and systemic fluconazole, but her ocular condition did not improve. Although the lesion showed temporary improvement, ocular pain and corneal ulcer recurred 3 months later

2019 Medicine

10. Severe congenital bilateral corneal ulceration due to Wolf-Hirschhorn syndrome: a case-report and review of the ophthalmic literature. (PubMed)

Severe congenital bilateral corneal ulceration due to Wolf-Hirschhorn syndrome: a case-report and review of the ophthalmic literature. A newborn boy with genetically confirmed Wolf-Hirschhorn syndrome presented with severe bilateral corneal ulceration that required emergency surgical tarsorrhaphies and permanent lower punctal occlusion. The patient healed completely, with no recurrence over 18 months of follow-up.Copyright © 2019 American Association for Pediatric Ophthalmology and Strabismus

2019 JAAPOS - Journal of the American Association for Pediatric Ophthalmology and Strabismus

11. Corneal ulceration and episcleritis associated with Wiskott–Aldrich syndrome (PubMed)

Corneal ulceration and episcleritis associated with Wiskott–Aldrich syndrome To present anterior segment ophthalmic manifestations of Wiskott-Aldrich syndrome (WAS), a rare X-linked primary immune-deficiency.A 15-year old male with WAS presented with multiple corneal ulcers of the left eye. Once resolved, this was followed by separate episodes of episcleritis in the left eye and corneal infiltrates of the right eye. Successful treatment included topical antibiotics and anti

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2016 American journal of ophthalmology case reports

12. Identification and antimicrobial susceptibility of microorganisms isolated from severe corneal ulcers of dogs in Thailand (PubMed)

Identification and antimicrobial susceptibility of microorganisms isolated from severe corneal ulcers of dogs in Thailand This study aims to determine the microbiological profile and risk factors associated with antimicrobial-resistant bacteria in canine severe corneal ulcers. Thirty-two corneal and conjunctival swabs were collected from dogs with diagnosed severe corneal ulcers that presented to Prasu-Arthorn veterinary teaching hospital in Nakhon Pathom, Thailand from June 2015 to June 2016 (...) active against staphylococci (81.3% susceptible). The width (P=0.02) and the depth (P=0.04) of ulcers predicted greater risk of yielding resistant bacteria. The identification of antimicrobial-resistant bacteria prompts practitioners to be prudent when choosing ophthalmic antibiotics for severe corneal ulcers.

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2018 The Journal of Veterinary Medical Science

13. Clinical Efficacy of Platelet-Rich Plasma in the Treatment of Neurotrophic Corneal Ulcer (PubMed)

Clinical Efficacy of Platelet-Rich Plasma in the Treatment of Neurotrophic Corneal Ulcer Platelet-rich plasma (PRP) is an autologous blood product without preservatives and rich in proteins and growth factors which make it possible for cells to differentiate, proliferate, and migrate, thus stimulating healing and regeneration of tissues. The aim of this study was to evaluate the efficiency of autologous platelet-rich plasma in the treatment of neurotrophic keratopathy.The study group consists (...) of 25 patients with nonhealing corneal ulcers due to herpes simplex or herpes zoster infection and facial nerve or trigeminal nerve paralysis as a result of a neurosurgical operation caused by a tumour or stroke. The patients were given autologous platelet-rich plasma drops five times a day and additionally preservative-free artificial tears and a vitamin A ointment at night for maximum 3 months. The following were evaluated: best corrected visual acuity (BCVA), healing of corneal surface

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2018 Journal of ophthalmology

14. Village-Integrated Eye Worker trial (VIEW): rationale and design of a cluster-randomised trial to prevent corneal ulcers in resource-limited settings. (PubMed)

Village-Integrated Eye Worker trial (VIEW): rationale and design of a cluster-randomised trial to prevent corneal ulcers in resource-limited settings. Corneal opacity is a leading cause of blindness worldwide. In resource-limited settings, untreated traumatic corneal abrasions may result in infection and ultimately, opacity. Although antimicrobial treatment of corneal ulcers may successfully cure infections, the scarring that accompanies the resolution of infection can still result in visual (...) impairment. Prevention may be the optimal approach for reducing corneal blindness. Studies have employed community health workers to provide prompt administration of antimicrobials after corneal abrasions to prevent infections, but these studies were not designed to determine the effectiveness of such a programme.The Village-Integrated Eye Worker trial (VIEW) is a cluster-randomised trial designed to assess the effectiveness of a community health worker intervention to prevent corneal ulcers. Twenty-four

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2018 BMJ open

15. Cenegermin (Oxervate) - Treatment of moderate (persistent epithelial defect) or severe (corneal ulcer) neurotrophic keratitis in adults

Cenegermin (Oxervate) - Treatment of moderate (persistent epithelial defect) or severe (corneal ulcer) neurotrophic keratitis in adults Published 08 October 2018 . Statement of advice SMC2124 cenegermin 20micrograms/ml eye drops, solution (Oxervate®) Dompé UK Ltd In confidence 7 September 2018 ADVICE: in the absence of a submission from the holder of the marketing authorisation cenegermin (Oxervate®) is not recommended for use within NHSScotland. Indication under review: Treatment of moderate (...) (persistent epithelial defect) or severe (corneal ulcer) neurotrophic keratitis in adults. The holder of the marketing authorisation has not made a submission to SMC regarding this product in this indication. As a result we cannot recommend its use within NHSScotland. Advice context: No part of this advice may be used without the whole of the advice being quoted in full. This advice represents the view of the Scottish Medicines Consortium and was arrived at after careful consideration and evaluation

2018 Scottish Medicines Consortium

16. Spontaneous Corneal Hydrops in a Patient with a Corneal Ulcer (PubMed)

Spontaneous Corneal Hydrops in a Patient with a Corneal Ulcer We report the case of a 77-year-old man with no history of keratoconus or other ectatic disorders who presented with corneal hydrops in the setting of a corneal ulcer. The risk factors, pathogenesis and treatment options of corneal hydrops are discussed.This is an observational case report study.A 77-year-old man presented with a 1-day history of severe pain, redness, mucous discharge and photophobia in the right eye. A slit-lamp (...) examination of the right eye showed an area of focal corneal edema and protrusion. Within the area of edema and protrusion, there was an infiltrate with an overlying epithelial defect consistent with an infectious corneal ulcer. The Seidel test showed no leakage, so a clinical diagnosis of corneal hydrops associated with nonperforated corneal ulcer was made. With appropriate antibiotic treatment, the corneal ulcer and hydrops both resolved over a 1-month period.Corneal hydrops can occur in the setting

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2016 Case reports in ophthalmology

17. Corneal cross-linking in the treatment of corneal ulcers. (PubMed)

Corneal cross-linking in the treatment of corneal ulcers. New treatments for corneal ulcers are needed to address challenges with antibiotic resistance, cost, and specificity requiring timely pathogen identification. This review assesses the evidence regarding safety and efficacy of corneal cross-linking (CXL) as an adjunct or stand-alone treatment.To date approximately 200 clinical cases of CXL used with various types of infectious keratitis have been reported in about 30 publications. Most (...) was used successfully as a monotherapy in approximately 16 eyes with early bacterial or shallow fungal infections.Further work is needed to develop optimized CXL protocols for treatment of corneal ulcers, define the appropriate conditions for use, and determine the safety and efficacy relative to standard antibiotic treatments.

2016 Current Opinion in Ophthalmology

18. Gatifloxacin 0.3% Versus Fortified Tobramycin-Cefazolin in Treating Nonperforated Bacterial Corneal Ulcers: Randomized, Controlled Trial. (PubMed)

Gatifloxacin 0.3% Versus Fortified Tobramycin-Cefazolin in Treating Nonperforated Bacterial Corneal Ulcers: Randomized, Controlled Trial. 27227400 2017 04 11 2018 12 02 1536-4798 35 8 2016 08 Cornea Cornea Gatifloxacin 0.3% Versus Fortified Tobramycin-Cefazolin in Treating Nonperforated Bacterial Corneal Ulcers: Randomized, Controlled Trial. e22-3 10.1097/ICO.0000000000000897 Bashir Hafsa H Cornea and Refractive Surgery Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India. Dave (...) Abhishek A Mathur Umang U eng Journal Article Comment United States Cornea 8216186 0277-3740 0 Anti-Bacterial Agents 0 Fluoroquinolones IHS69L0Y4T Cefazolin VZ8RRZ51VK Tobramycin IM Cornea. 2016 Jan;35(1):56-61 26509763 Cornea. 2016 Aug;35(8):e23 27387406 Anti-Bacterial Agents therapeutic use Cefazolin therapeutic use Corneal Ulcer drug therapy Drug Therapy, Combination Eye Infections, Bacterial drug therapy Fluoroquinolones therapeutic use Humans Tobramycin therapeutic use 2016 5 27 6 0 2016 5 27 6 0

2017 Cornea

19. Predictors of Corneal Perforation or Need for Therapeutic Keratoplasty in Severe Fungal Keratitis: A Secondary Analysis of the Mycotic Ulcer Treatment Trial II. (PubMed)

Predictors of Corneal Perforation or Need for Therapeutic Keratoplasty in Severe Fungal Keratitis: A Secondary Analysis of the Mycotic Ulcer Treatment Trial II. Identifying patients with infectious keratitis who are at risk of experiencing a poor outcome may be useful to allocate resources toward high-risk patients, particularly in resource-poor settings.To determine baseline patient and ulcer characteristics that predict a high risk of developing corneal perforation and/or the need to undergo (...) therapeutic penetrating keratoplasty (TPK).This is a secondary analysis of Mycotic Ulcer Treatment Trial II, a multicenter, double-masked, placebo-controlled randomized clinical trial that enrolled 240 patients with smear-positive filamentous fungal corneal ulcers who enrolled between May 2010 and August 2015. Participants had a baseline visual acuity of 20/400 or worse and were randomized to receive oral voriconazole or a placebo (all participants received topical voriconazole, 1%). After 39 participants

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2017 JAMA ophthalmology

20. Corneal perforation from peripheral ulcerative keratopathy in patients with rheumatoid arthritis: epidemiological findings of the British Ophthalmological Surveillance Unit. (PubMed)

Corneal perforation from peripheral ulcerative keratopathy in patients with rheumatoid arthritis: epidemiological findings of the British Ophthalmological Surveillance Unit. This study quantifies the threat to vision and the survival in patients presenting with peripheral ulcerative keratopathy (PUK) corneal perforation associated with rheumatoid arthritis (RA) in the UK.New cases of corneal perforation from PUK in patients with RA were prospectively collected from the UK via the British (...) , topical and oral antibiotics, and lubricants. Long-term management included corneal grafting in 12/20 (60%) eyes of patients living at 1 year. The 1-year all-cause mortality was 6/25 (24%), which increased to 1/2 (50%) if both eyes had perforated. In the remaining patients alive at 1-year follow-up, there was a 13/20 (65%) poor visual outcome of less than or equal to counting fingers. 8/25 (40%) patients had bilateral PUK, with 2/25 (8%) having bilateral perforation. 5/19 (26%) patients alive at 1

2017 British Journal of Ophthalmology

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