Posters

The interest of the amniotic membrane graft in corneal perforations on post-zoster neurotrophic keratitis followed by OCT

Poster Details

First Author: Y.Debbabi MOROCCO

Co Author(s): Y. Malek   N. Laaribi   Y. Mouzari   F. El Asri   R. Karim   A. Oubaaz     

Abstract Details

Purpose:

The surgical use of human amniotic membrane in ocular pathology is still recent. Moreover, we know that OCT can visualize, in high resolution and without contact, the structures of the anterior segment and in particular the cornea. We report the case of a patient with a perforating neurotrophic corneal ulcer successfully treated with amniotic membrane grafting. OCT has allowed us to track and document the process of healing perforation.

Setting:

Patient admitted and followed at the ophthalmology department of the military training hospital Mohammed V in Rabat, Morocco

Methods:

A 55-year-old patient was referred to us for a right-sided neurotrophic corneal ulcer in a history of recurrent corneal ulcer disease of herpetic origin awaiting corneal transplantation The examination found visual acuity to finger movements, conjunctival hyperemia, corneal hypoaesthesia, central perforating corneal punctiform ulcer with positive seidel, significant peripheral neovascularization and an uncomplicated anterior chamber. The patient was blessed with an amniotic membrane graft associated with therapeutic contact lens placement. Antibiotics, topical steroids and antiviral treatment with VO were started postoperatively

Results:

Evolution under this treatment was favorable with progressive closure of ulceration and reformation of an anterior chamber and a clear decrease in corneal neovascularization. OCT monitoring allowed us to accurately quantify the degree of corneal infiltration around the perforation, which increased from 696 μm to 510 μm; as well as remodeling and post-graft epithelio-stromal reconstruction day after day with the closure of the perforation and then an increase in corneal thickness from 40 μm to 340 μm we were also able to follow, day after day, the evolution of the anterior chamber,

Conclusions:

Amniotic transplantation is a simple and easily accessible surgical technique that must be part of the therapeutic arsenal for the treatment of secondary ulcer, OCT provides non-invasive images of the anterior segment in high resolution. This allowed us to follow the healing of a perforating corneal ulcer. however, amniotic membrane grafting and OCT follow-up require a surgeon and an experienced ophthalmologist for success and good patient follow-up.

Financial Disclosure:

None