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Management of a neurotrophic deep corneal ulcer with amniotic membrane transplantation in a patient with functional monocular vision: A case report.

Abstract Amniotic membrane transplantation (AMT) has been performed therapeutically in humans for over 100 years. In recent 2 decades AMTs have been used increasingly and successfully to treat various types of ophthalmic indications.
PMID
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Authors

Mayor MeshTerms

Vision, Monocular

Keywords
Journal Title medicine
Publication Year Start




PMID- 29390295
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 50
DP  - 2017 Dec
TI  - Management of a neurotrophic deep corneal ulcer with amniotic membrane
      transplantation in a patient with functional monocular vision: A case report.
PG  - e8997
LID - 10.1097/MD.0000000000008997 [doi]
AB  - RATIONALE: Amniotic membrane transplantation (AMT) has been performed
      therapeutically in humans for over 100 years. In recent 2 decades AMTs have been 
      used increasingly and successfully to treat various types of ophthalmic
      indications. PATIENT CONCERNS: An 83-year-old man was referred to our eye
      hospital with a refractory neurotrophic deep corneal ulcer of the left eye.
      DIAGNOSES: The best-corrected visual acuity of the left eye was 0.5 (0.3 logMAR) 
      and of the right eye was 0.05 (1.3 logMAR), which was caused by a central retinal
      vein occlusion 5 years previously. In cases of binocular vision, a large amniotic
      membrane patch can cover the whole cornea, including the optical axis. However,
      in cases with functional monocular vision, as in the case reported here, the AMT 
      has to be performed without the involvement of the optical axis to ensure vision 
      for the patient. Otherwise the patient would have a massively restricted view
      like looking through waxed paper for at least 2-4 weeks until the overlay
      dissolved. INTERVENTIONS: For this case, an AMT using a modified sandwich
      technique was applied without involvement of the optic axis to ensure vision for 
      the patient. This case report illustrates this eye's course of healing over time.
      OUTCOMES: A reduction in the inflammation and healing of the corneal ulcer could 
      be seen. In addition, the corneal vascularization decreased. Six months after the
      AMT, a slit-lamp examination revealed stable findings. The best-corrected visual 
      acuity of the left eye had increased to 0.8 (0.1 logMAR). LESSONS: To the best of
      our knowledge, a case report on the management of a neurotrophic deep corneal
      ulcer with AMT in a patient with functional monocular vision has never been
      undertaken before.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Rock, Tobias
AU  - Rock T
FAU - Bartz-Schmidt, Karl Ulrich
AU  - Bartz-Schmidt KU
FAU - Rock, Daniel
AU  - Rock D
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Aged, 80 and over
MH  - Amnion/*transplantation
MH  - Corneal Ulcer/*surgery
MH  - Humans
MH  - Male
MH  - *Vision, Monocular
MH  - Visual Acuity
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000008997 [doi]
AID - 00005792-201712150-00045 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(50):e8997. doi: 10.1097/MD.0000000000008997.