Amniotic membrane, AC washout, steroids effective as peripheral ulcerative keratitis treatment
Amniotic membrane transplantation combined with anterior chamber washout and topical corticosteroids yielded favorable results in the treatment of severe peripheral ulcerative keratitis with membranous endothelial exudation, according to a study.
The prospective study included 12 eyes of 12 patients with peripheral ulcerative keratitis. Mean patient age was 58.3 years.
Ulcers were identified at the corneal periphery and were accompanied by central corneal epithelial defects and stromal edema. Anterior segment optical coherence tomography was used to observe membranous endothelial exudates. Mean duration of ulcers before treatment was 3 months.
Persistent corneal inflammation and ulceration did not respond to topical anti-inflammatory therapy.
No signs of bacterial, fungal or Acanthamoeba infection were identified, according to the researchers.
Necrotic corneal tissue was cut and exudation adhering to the endothelium was removed. Amniotic membrane was placed on the corneal lesion.
Corticosteroid eye drops, along with topical and systemic anti-inflammation medications, were administered postoperatively. Slit lamp biomicroscopy was used to detect healing of corneal ulcers and reduction of stromal edema. Mean follow-up was 6.5 months.
All corneal ulcers healed by 1 to 2 weeks postoperatively, and corneal stromal edema diminished within 1 month according to the researchers. Ocular surface stability was achieved in all patients, and no recurrence of ulcers occurred during follow-up. Visual acuity improved and IOP was normal in all eyes at final follow-up, the authors said.
Disclosure: The authors have no relevant financial disclosures.