Sterile corneal epithelial defect associated with hypopyon

RESUMO

Noninfectious epithelial defect is characterized by absence of stromal cellular infiltration. Hypopyon is usually associated with stromal infiltration (bacterial, viral and fungal ulcers). Noninfectious hypopyon may occur in uveitis (e.g. Behcet's Syndrome) without epithelial defect. We repost 6 cases of corneal epithelial defect with hypopyon irydocyclitis 3 related with bullous keratopathy, 2 with contact lenses and 1 with neurotrophic keratopathy. Studies have been done suggesting that the persistence of an epithelial defect increases the regular secretion of tPA (tissue plasminogen activator) from the focal contacts of the basal cell surfaces at the edge of the epithelial sheet. The resulting increased secretion of tPA, instead of promotion epithelial healing, promotes delay or nonhealing of the defect and according to our study, the development of stromal ulceration and hypopyon. With this studies, we hope to emphasize that hypopyon can be seen in any patient with sterile corneal epithelial defect, whatever the etiology is, as the level of tPA is increased when a corneal epithelial defect is present. Patching and/or a bandage contact lens are often helpful, inducing a prompt epithelial healing.