A Differentiated Approach to the Complex Treatment of Cornea Ulcers
Ulcerative lesions of the cornea in 17–21 % lead to functional and up to 8 % to anatomical death of the eye depending on the severity. The aim of the work was to develop an algorithm of surgical treatment of patients with corneal ulcers. Comprehensive examination, treatment and outcomes in the dynam...
| Main Authors: | , , |
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| Format: | Article |
| Language: | Russian |
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Ophthalmology Publishing Group
2018-10-01
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| Series: | Oftalʹmologiâ |
| Subjects: | |
| Online Access: | https://www.ophthalmojournal.com/opht/article/view/685 |
| _version_ | 1827063161193234432 |
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| author | E. V. Chentsova E. N. Verigo A. I. Hazamova |
| author_facet | E. V. Chentsova E. N. Verigo A. I. Hazamova |
| author_sort | E. V. Chentsova |
| collection | DOAJ |
| description | Ulcerative lesions of the cornea in 17–21 % lead to functional and up to 8 % to anatomical death of the eye depending on the severity. The aim of the work was to develop an algorithm of surgical treatment of patients with corneal ulcers. Comprehensive examination, treatment and outcomes in the dynamics of ulcerative lesions was performed in 126 patients, 86 patients of them received surgical intervention (with the threat of corneal perforation or present) for emergency indications and in 40 cases combined treatment was carried out with the use of a crosslinking (CRL) in corneal ulcer and ulcer a corneal transplant. Surgical intervention included autoconjuctival plasty (AUC), the transplantation of amniotic membrane in combination with blepharorrhaphy (TAM + BR), lamellar keratoplasty (PKP), penetrating keratoplasty (PK), reconstructive keratoplasty (RCP). The most favorable outcomes with relief of inflammation were achieved in RCP and PC. In cases of delayed epithelialization of the cornea and graft (herpesvirus infection and trophic disorders), the most resonant ones were TAM and TAM + BR. CRL treatment was carried out in 3 variants: 1-as the main method of treatment, 2 — CRL in combination with TAM + BR, 3 — CRL + keratoplasty ( 5–7 days after surgery). As a treatment result, epithelialization of ulcerative-destructive process and partial increase in visual acuity were observed in all patients. Based on the results of patient’s treatment the algorithm of complex surgical care was created. It takes into account the etiology, localization, depth and severity of the inflammatory process, the area of ulcerative lesions of the cornea and of the graft, reduced terms of treatment inflammation and rehabilitation period. |
| first_indexed | 2024-04-10T01:47:35Z |
| format | Article |
| id | doaj.art-3e2bf2922a324cbba96559868ccd57bc |
| institution | Directory Open Access Journal |
| issn | 1816-5095 2500-0845 |
| language | Russian |
| last_indexed | 2025-02-18T20:09:43Z |
| publishDate | 2018-10-01 |
| publisher | Ophthalmology Publishing Group |
| record_format | Article |
| series | Oftalʹmologiâ |
| spelling | doaj.art-3e2bf2922a324cbba96559868ccd57bc2024-10-17T16:11:57ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452018-10-0115325626310.18008/1816-5095-2018-3-256-263450A Differentiated Approach to the Complex Treatment of Cornea UlcersE. V. Chentsova0E. N. Verigo1A. I. Hazamova2Moscow Helmholtz Research Institute of Eye DiseasesMoscow Helmholtz Research Institute of Eye DiseasesMoscow Helmholtz Research Institute of Eye DiseasesUlcerative lesions of the cornea in 17–21 % lead to functional and up to 8 % to anatomical death of the eye depending on the severity. The aim of the work was to develop an algorithm of surgical treatment of patients with corneal ulcers. Comprehensive examination, treatment and outcomes in the dynamics of ulcerative lesions was performed in 126 patients, 86 patients of them received surgical intervention (with the threat of corneal perforation or present) for emergency indications and in 40 cases combined treatment was carried out with the use of a crosslinking (CRL) in corneal ulcer and ulcer a corneal transplant. Surgical intervention included autoconjuctival plasty (AUC), the transplantation of amniotic membrane in combination with blepharorrhaphy (TAM + BR), lamellar keratoplasty (PKP), penetrating keratoplasty (PK), reconstructive keratoplasty (RCP). The most favorable outcomes with relief of inflammation were achieved in RCP and PC. In cases of delayed epithelialization of the cornea and graft (herpesvirus infection and trophic disorders), the most resonant ones were TAM and TAM + BR. CRL treatment was carried out in 3 variants: 1-as the main method of treatment, 2 — CRL in combination with TAM + BR, 3 — CRL + keratoplasty ( 5–7 days after surgery). As a treatment result, epithelialization of ulcerative-destructive process and partial increase in visual acuity were observed in all patients. Based on the results of patient’s treatment the algorithm of complex surgical care was created. It takes into account the etiology, localization, depth and severity of the inflammatory process, the area of ulcerative lesions of the cornea and of the graft, reduced terms of treatment inflammation and rehabilitation period.https://www.ophthalmojournal.com/opht/article/view/685corneal ulcerpersistent corneal erosionoptical coherence tomographycrosslinkingkeratoplastyamniotic membrane transplantation |
| spellingShingle | E. V. Chentsova E. N. Verigo A. I. Hazamova A Differentiated Approach to the Complex Treatment of Cornea Ulcers Oftalʹmologiâ corneal ulcer persistent corneal erosion optical coherence tomography crosslinking keratoplasty amniotic membrane transplantation |
| title | A Differentiated Approach to the Complex Treatment of Cornea Ulcers |
| title_full | A Differentiated Approach to the Complex Treatment of Cornea Ulcers |
| title_fullStr | A Differentiated Approach to the Complex Treatment of Cornea Ulcers |
| title_full_unstemmed | A Differentiated Approach to the Complex Treatment of Cornea Ulcers |
| title_short | A Differentiated Approach to the Complex Treatment of Cornea Ulcers |
| title_sort | differentiated approach to the complex treatment of cornea ulcers |
| topic | corneal ulcer persistent corneal erosion optical coherence tomography crosslinking keratoplasty amniotic membrane transplantation |
| url | https://www.ophthalmojournal.com/opht/article/view/685 |
| work_keys_str_mv | AT evchentsova adifferentiatedapproachtothecomplextreatmentofcorneaulcers AT enverigo adifferentiatedapproachtothecomplextreatmentofcorneaulcers AT aihazamova adifferentiatedapproachtothecomplextreatmentofcorneaulcers AT evchentsova differentiatedapproachtothecomplextreatmentofcorneaulcers AT enverigo differentiatedapproachtothecomplextreatmentofcorneaulcers AT aihazamova differentiatedapproachtothecomplextreatmentofcorneaulcers |