Posters

Management of corneal perforation following keratitis with amniotic membrane graft: about a case

Poster Details

First Author: K.Bouirig MOROCCO

Co Author(s):    K. Bouirig   A. Kougou Ntoutoume   M. Bentaleb   A. Amazouzi   O. Cherkaoui        

Abstract Details

Purpose:

to present the surgical outcome of a small corneal perforation following keratitis

Setting:

Opthalmology A department , speciality hospital ,Rabat , Morocco

Methods:

A 60 year-old man,presented with left red eye and decreased VA for a significant week.The history releaved iterative episodes since 2006 of herpetic keratitis of the right eye complicated by corneal perforation leading to endophtalmitis and phtisis bulbi and subsequently required enucleation 8 years ago.Ophthalmic examination showed :VA positif light perception ,decreased corneal sensitivity,peripheral corneal perforation measuring 2mm in diameter and iris prolapse a shallow anterior chamber , filled with white hypopion occupied 25% of the space,a cataract explaining the difficulty to examinate the fundus .Ultrasound examination was performed, had shown a clear vitreous ,so that endophtalmitis could be eliminated

Results:

microbiologycal resultats and herpes culture returned negative The patient received local fortified antibiotics, cycloplegia , wet agents , acyclovir 3g per day and systemic antibiotic therapy. The patient received Subjonctival corticosteroid injection after few days. An amniotic membrane was used to cover the perforation The follow up after 2 weeks showed the disappearance of hypopion and discrease in corneal oedema , Visual improvement to " hand motion "

Conclusions:

The biogical property of amniotic membrane make it a useful tool in the managment of corneal ulceration and perforation . It has variety of indication , provides mechanical protection , promotes reepitalization ,and reduces inflammation . There is no risk of rejection. However, the risk of persistent or recurrent infection necessitates continued use of prophylactic acyclovir therapy in our case and patient monitoring. The choice of the treatment of the corneal perforation depends one the size , location and status of underlying diseases .

Financial Disclosure:

None