ABSTRACT
PURPOSE: To assess amniotic membrane retention after amniotic membrane transplant in bullous keratopathy patients and whether there were any corneal structural changes that may hinder further penetrating keratoplasty Methods: A retrospective study including 22 patients who have undergone amniotic membrane transplant from 1 Jan 1998 till 30 Jun 2016. Confocal microscopy and anterior segment optical coherence tomography (ASOCT) were performed to assess the retention of amniotic membrane and to detect any corneal structural changes. The comparison was made with 5 controls who had bullous keratopathy awaiting endothelial keratoplasty. RESULTS: Patients had a mean follow-up of 61 ± 33.7 months. Pain reduction was significant (p < .001) although it did not significantly correlate with the regularity of the superficial, intermediate or basal epithelial layers, nor with the retention of the amniotic membrane. No long-term structural changes that may hinder future penetrating keratoplasty were detected. CONCLUSION: This procedure is a safe and effective long-term treatment for symptomatic bullous keratopathy patients.
Subject(s)
Amnion/transplantation , Anterior Eye Segment/diagnostic imaging , Cornea/pathology , Corneal Edema/surgery , Adult , Aged , Aged, 80 and over , Cornea/diagnostic imaging , Corneal Edema/diagnostic imaging , Female , Fibrosis/diagnostic imaging , Fibrosis/pathology , Graft Survival , Humans , Male , Microscopy, Confocal , Middle Aged , Retrospective Studies , Tomography, Optical Coherence/methodsABSTRACT
A 43-year-old man suffering from Klebsiella liver abscess and bacteraemia presented with left eye visual disturbance a few days after admission. His visual acuity was 6/6. There was a whitish subretinal mass located at the temporal periphery without vitritis. His visual acuity dropped to 6/120 with marked vitritis 1 day later and a diagnosis of a subretinal abscess was made. The vitreous cultures were negative. Response was suboptimal with intravitreal antibiotics, and retinotomy, vitrectomy, antibiotic irrigation and silicone oil tamponade were required. His vision gradually improved to 6/60 with silicone oil in situ. This case illustrates the rare presentation of a subretinal abscess in endogenous endophthalmitis with no initial associated vitritis, and the importance of maintaining a high level of suspicion despite good visual acuity on presentation in cases with relevant history. Early detection and intervention, and close monitoring may salvage the patient's vision in such cases.
