التفاصيل البيبلوغرافية
| العنوان: |
Peripheral Ulcerative Keratitis in a Patient with Bilateral Scleritis: Medical and Surgical Management. |
| المؤلفون: |
Artaechevarria Artieda, June, Estébanez-Corrales, Nuria, Sánchez-Pernaute, Olga, Alejandre-Alba, Nicolás |
| المصدر: |
Case Reports in Ophthalmology; 2020, Vol. 11 Issue 3, p500-506, 7p |
| مصطلحات موضوعية: |
CORNEAL ulcer, AMNION, SCLERITIS, FEMTOSECOND lasers, CORNEAL transplantation, EYE pain, KERATOCONUS, CORNEAL opacity |
| مستخلص: |
Peripheral ulcerative keratitis (PUK) is a group of corneal disorders that cause peripheral corneal thinning, threatening globe integrity in advance stages. It is usually associated with systemic autoimmune diseases and management is based on local and systemic approaches. We present the case of a 47-year-old man with a previous history of bacterial keratitis in his left eye presenting with 1 month of bilateral ocular pain and redness. At examination, diffuse bilateral globe inflammation with paracentral corneal thinning in his left eye was observed. He was diagnosed with bilateral scleritis and PUK in his left eye. Workup for associated systemic autoimmune disease yielded negative results. The patient was started on pulses of intravenous methylprednisolone followed by oral prednisone failing to achieve sufficient control of the inflammatory syndrome. Subsequently, periodic intravenous cyclophosphamide was administered with a favorable response. A multilayer amniotic membrane graft was applied, but there was rapid melting with reabsorption of the tissue, resulting in extreme corneal thinning at the inferior paracentral cornea. A decentered 8.5-mm superficial anterior lamellar keratoplasty (SALK) was then performed obtaining the donor graft with a femtosecond laser but performing manual trepanation in the recipient. At 12 months, visual and biomicroscopic measures do not show deterioration and inflammation remains under control with oral azathioprine as maintenance regime. The management of PUK includes both systemic immunosuppression and tectonic procedures to preserve the globe integrity. Diverse surgical techniques have been attempted, but no definitive guidelines are available. Decentered large SALK is a simple technique that can yield acceptable visual results. [ABSTRACT FROM AUTHOR] |
|
Copyright of Case Reports in Ophthalmology is the property of Karger AG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder