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...

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Main Authors: E. V. Chentsova, E. N. Verigo, A. I. Hazamova
Format: Article
Language:Russian
Published: Ophthalmology Publishing Group 2018-10-01
Series:Oftalʹmologiâ
Subjects:
Online Access:https://www.ophthalmojournal.com/opht/article/view/685
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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.
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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