Corneal collagen cross-linking in a late-onset graft infectious ulcer: A case report

被引:10
作者
Labiris G. [1 ,2 ]
Giarmoukakis A. [2 ]
Larin R. [1 ,2 ]
Sideroudi H. [2 ]
Kozobolis V.P. [1 ,2 ]
机构
[1] Department of Ophthalmology, University Hospital of Alexandroupolis, 68100 Dragana, Alexandroupolis
[2] Eye Institute of Thrace, Alexandroupolis, Alexandroupolis
关键词
Corneal collagen cross-linking; Corneal ulcer; Penetrating keratoplasty;
D O I
10.1186/1752-1947-8-180
中图分类号
学科分类号
摘要
Introduction. Infectious keratitis following penetrating keratoplasty is a common postoperative complication. Intensive topical and systemic treatments do not always prevent the risk of graft failure. In this report we demonstrate the beneficial anti-microbial effect of corneal collagen cross-linking in a late-onset, sight-threatening, corneal graft ulcer. Case presentation. A 57-year old Caucasian man underwent penetrating keratoplasty in his left eye, due to corneal bullosa after cataract extraction surgery. Twelve months after the penetrating keratoplasty, he visited our emergency service complaining of burning and foreign body sensation in his operated eye. Slit-lamp examination revealed a central, round-shaped ulcer of the graft. Due to poor response to the intensive topical antibiotic therapy, corneal collagen cross-linking was applied 3 days after admission, in an attempt to control the infection. Cultures indicated the predominance of methicillin-resistant Staphylococcus aureus infection. Five days after corneal collagen cross-linking treatment, the epithelium was completely re-epithelized, while the transparency of the transplanted cornea was gradually restored within the 12-month follow-up period. No relapses occurred. Conclusion: Corneal collagen cross-linking seems to be a safe and effective therapeutic alternative in resistant cases of infectious keratitis following penetrating keratoplasty. © 2014 Labiris et al.; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 14 条
  • [1] Rahman I., Carley F., Hillarby C., Brahma A., Tullo A.B., Penetrating keratoplasty: Indications, outcomes, and complications, Eye, 23, pp. 1288-1294, (2009)
  • [2] Snibson G.R., Collagen cross-linking: A new treatment paradigm in corneal disease - A review, Clin Experiment Ophthalmol, 38, 2, pp. 141-153, (2010)
  • [3] Wollensak G., Spoerl E., Seiler T., Riboflavin/ultraviolet-A-induced collagen crosslinking for the treatment of keratoconus, American Journal of Ophthalmology, 135, 5, pp. 620-627, (2003)
  • [4] Kozobolis V., Labiris G., Gkika M., Sideroudi H., Kaloghianni E., Papadopoulou D., Toufexis G., UV-A collagen cross-linking treatment of bullous keratopathy combined with corneal ulcer, Cornea, 29, 2, pp. 235-238, (2010)
  • [5] Martins S.A., Combs J.C., Noguera G., Camacho W., Wittmann P., Walther R., Cano M., Dick J., Behrens A., Antimicrobial efficacy of riboflavin/UVA combination (365nm) in vitro for bacterial and fungal isolates: A potential new treatment for infectious keratitis, IOVS, 49, 8, pp. 3402-3408, (2008)
  • [6] Iseli H.P., Thiel M.A., Hafezi F., Kampmeier J., Seiler T., Ultraviolet A/riboflavin corneal cross-linking for infectious keratitis associated with corneal melts, Cornea, 27, 5, pp. 590-594, (2008)
  • [7] Li Z., Jhanji V., Tao X., Yu H., Chen W., Mu G., Riboflavin/ultraviolet light-mediated crosslinking for fungal keratitis, Br J Ophthalmol, 97, 5, pp. 669-671, (2013)
  • [8] Gkika M., Labiris G., Kozobolis V., Corneal collagen cross-linking using riboflavin and ultraviolet-A irradiation: A review of clinical and experimental studies, Int Ophthalmol, 31, 4, pp. 309-319, (2011)
  • [9] Kozobolis V., Labiris G., Gkika M., Sideroudi H., Additional applications of corneal cross linking, Open Ophthalmol J, 11, 5, pp. 17-18, (2011)
  • [10] Kumar V., Lockerbie O., Keil S.D., Ruane P.H., Platz M.S., Martin C.B., Ravanat J.L., Cadet J., Goodrich R.P., Riboflavin and UV-light based pathogen reduction: Extent and consequence of DNA damage at the molecular level, Photochem Photobiol, 80, pp. 15-21, (2004)