[A method of treating purulent corneal ulcer in the eyes with neuroparalytical keratitis and lagophthalmos].

PURPOSE To develop a method for treatment of advanced purulent corneal ulcers in eyes with neurotrophic keratitis that developed as a complication of intracranial pathological processes or brain surgeries. MATERIAL AND METHODS The study involved 13 patients (14 eyes) that underwent combined surgery - keratoplasty, autoconjunctival flap covering, partial tarsorrhaphy performed simultaneously. Before and after the surgery, patients received frequent instillations of antimicrobial agents and autologous serum. RESULTS The organ of vision was preserved in all patients, visual function - in 50% of cases, it improved in 35.7% of cases from 0.07±0.05 to 0.26±0.11. Lagophthalmos has decreased from 6.11±0.99 to 2.78±0.62 mm. CONCLUSION Patients with intracranial lesions and complicated by neurotrophic keratitis and lagophthalmos often develop advanced severe and progressive corneal purulent ulcers, which seldom respond to the most active conservative therapy. Simultaneous surgery that includes keratoplasty, auto conjunctival flap covering and partial superficial tarsorrhaphy is an effective treatment option that helps preserve visual function in such eyes.

[1]  A. Nurden The biology of the platelet with special reference to inflammation, wound healing and immunity. , 2018, Frontiers in bioscience.

[2]  L. Mastropasqua,et al.  Understanding the Pathogenesis of Neurotrophic Keratitis: The Role of Corneal Nerves , 2017, Journal of cellular physiology.

[3]  Dirk Strunk,et al.  Human platelet lysate: Replacing fetal bovine serum as a gold standard for human cell propagation? , 2016, Biomaterials.

[4]  E. Kasparova [Modern treatments for purulent corneal ulcers]. , 2016, Vestnik oftalmologii.

[5]  T. Chikama,et al.  Potential New Modes of Treatment of Neurotrophic Keratopathy , 2015, Cornea.

[6]  E. Kasparova [Purulent corneal ulcers: etiology, pathogenesis, classification]. , 2015, Vestnik oftalmologii.

[7]  Yu-Wen Wu,et al.  Antimicrobial activity of platelet (PLT)‐poor plasma, PLT‐rich plasma, PLT gel, and solvent/detergent‐treated PLT lysate biomaterials against wound bacteria , 2013, Transfusion.

[8]  G. Geerling,et al.  Autologous serum eye drops for ocular surface disorders , 2004, British Journal of Ophthalmology.

[9]  H. Handa,et al.  Substance P‐induced cadherin expression and its signal transduction in a cloned human corneal epithelial cell line , 2000, Journal of cellular physiology.

[10]  K. Tsubota,et al.  Serum Application for the Treatment of Ocular Surface Disorders , 2000, International ophthalmology clinics.

[11]  K. Tsubota,et al.  Treatment of dry eye by autologous serum application in Sjögren’s syndrome , 1999 .

[12]  H. Dua The conjunctiva in corneal epithelial wound healing , 1998, The British journal of ophthalmology.

[13]  C. Murphy,et al.  Stimulation of epithelial cell growth by the neuropeptide substance P , 1993, Journal of cellular biochemistry.

[14]  Timo Tervo,et al.  EPIDERMAL GROWTH FACTOR (EGF) IN OCULAR FLUIDS: PRESENCE, ORIGIN AND THERAPEUTICAL CONSIDERATIONS , 1992, Acta ophthalmologica. Supplement.

[15]  R. Buck Ultrastructure of conjunctival epithelium replacing corneal epithelium. , 1986, Current eye research.

[16]  N. Newman,et al.  Walsh and Hoyt's Clinical Neuro Ophthalmology , 1982 .

[17]  J. Friend,et al.  Corneal re-epithelialization from the conjunctiva. , 1981, Investigative ophthalmology & visual science.