DOI: https://doi.org/10.22141/2309-8147.7.2.2019.169688

Efficacy of epi-on cross-linking of non-healing corneal ulcer: a case report

Т.А. Тabalyuk, А.S. Vavryshchuk, L.М. Rudavska, І.V. Кudryl

Abstract


The article deals with a case report of non-healing posttraumatic corneal ulcer. An epi-on cross-linking was performed for left eye in 37-year old female patient, who has been unsuccessfully treated, including transplantation of amnion membrane, for 3.5 months after corneal abrasion. After corneal soaking with Riboflavin (one drop each 2 minutes during half an hour), an UV-A irradiation 380 nm (3 mV/cm2) 9.0 mm in diameter was performed with frequent additional BSS moisturizing. Patient was assessed preoperatively and 1 day, 1 week, 1, 3 and 9 months after procedure. Clinical efficacy of epi-on cross-linking has been shown. No side effects were observed during the follow-up period. Painful, corneal, oedematous syndromes were relieved gradually, within 9 months; uncorrected visual acuity improved from 0.2 to 0.5; best corrected visual acuity changed to 0.7; topometric, keratometric, pachymetric data normalized; corneal irregularity disappeared. These assertions are confirmed by instrumental investigation with Pentacam HR (Oculus, Germany) and its Sheimpflug images.

Keywords


corneal ulcer; collagen cross-linking; Pentacam; riboflavin; ultraviolet A

References


Аверьянова О.С., Ковалев А.И. Терапевтическая керат­эктомия в лечении помутнений роговицы после герпетических кератитов: оптимизация параметров // Сучасні медичні технології. — 2012. — № 2. — С. 9.

Бойко Э.В., Ян А.В., Агеев B.C., Синявский О.В. Оценка возможностей лазерной коагуляции излучением среднего ИК-диапазона как метода санации гнойных язв роговицы // Научно-практическая конференция «Лазеры в офтальмологии: вчера, сегодня, завтра». — М., 2009. — 122-125.

Зайцев А.В., Каспарова Е.А. Нетрансплантационные методы лечения язв роговицы // Вестник офтальмологии. — 2012. — № 5. — С. 65-67.

Bennett H.G., Hay J., Kirkness C.M., Seal D.V., Devonshire P. Antimicrobial management of presumed microbial keratitis: Guidelines for treatment of central and peripheral ulcers // Br. J. Ophthalmol. — 1998. — 82. — 137-145.

Edelstein S.L., Wichiensin P., Huang A.J. Bacterial keratitis // Krachmer J.H., Mannis M.J., Holland E.J., editors. Cornea. — Philadelphia: Mosby, Elsevier, 2011. — Р. 919-944.

Gokhale N.S. Medical management approach to infectious keratitis // Indian J. Ophthalmol. — 2008. — 56. — 215-220.

Hafezi F. Cross-linking of corneal collagen with UVA and riboflavin for the treatment of corneal disease // Iran J. Ophthalmol. — 2009. — 21. — 3-12.

Iakovleva M.B., Kozel’tsev V.L. Proteolysis of collagen by several species of micromycetes and spore-forming bacteria // Prikl. Biokhim. Mikrobiol. — 1994. — 30. — 121-126.

Levy S.B. Multidrug resistance — A sign of the times // N. Engl. J. Med. — 1998. — 338. — 1376-1378.

Makdoumi K., Mortensen J., Crafoord S. Infectious keratitis trea­ted with corneal crosslinking // Cornea. — 2010. — 29. — 1353-1358.

Martins S.A., Combs J.C., Noguera G., Camacho W., Wittmann P., Walther R. et al. Antimicrobial efficacy of riboflavin/UVA combination (365 nm) in vitro for bacterial and fungal isolates: A potential new treatment for infectious keratitis // Invest. Ophthalmol. Vis. Sci. — 2008. — 49. — 3402-3408.

Morén H., Malmsjö M., Mortensen J., Ohrström A. Riboflavin and ultraviolet a collagen crosslinking of the cornea for the treatment of keratitis // Cornea. — 2010. — 29. — 102-104.

Panda A., Krishna S.N., Kumar S. Photo-activated riboflavin therapy of refractory corneal ulcers // Cornea. — 2012. — 31. — 1210-1213.

Price M.O., Price F.W. Corneal cross-linking in the treatment of corneal ulcers // Current Opinion in Ophthalmology. — May 2016. — 27(3). — 250-255.

Simmons D.M., Kearney J.N. Evaluation of collagen cross-linking techniques for the stabilization of tissue matrices // Biotechnol. Appl. Biochem. — 1993. — 17 (Pt 1). — 23-29.

Spoerl E., Wollensak G., Seiler T. Increased resistance of crosslinked cornea against enzymatic digestion // Curr. Eye Res. — 2004. — 29. — 35-40.

Wollensak G., Spoerl E., Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus // Am. J. Ophthalmol. — 2003. — 135. — 620-627.

Zamani M., Panahi-Bazaz M., Assadi M. Corneal Collagen Cross-linking for Treatment on Non-Healing Corneal Ulcers // J. Ophthalmic Vis. Res. — 2015 Jan-Mar. — 10(1). — 16-20.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 

© "Publishing House "Zaslavsky", 1997-2019

 

   Seo анализ сайта