Showing papers on "corneal ulcer published in 1977"

[Allograft rejection reactions after keratoplasty (author's transl)]

Abstract: Immune reactions against corneal transplants cause most of the graft failures during the first 24 months after keratoplasty. This is partly due to inadequate diagnosis and therapy. After a short discussion of the experimental and clinical background, different kinds of characteristic immune reactions are demonstrated by case descriptions and photos. The importance of immune reactions is substantiated by an evaluation of 88 recently performed keratoplasties. Finally, detailed suggestions are made for prophylaxis and therapy of postkeratoplasty immune reactions.

Ocular manifestations of toxic epidermal necrolysis associated with allopurinol use.

Abstract: • A 54-year-old man was receiving allopurinol therapy to treat hyperuricemia that followed an inferior wall, myocardial infarction. After three weeks of allopurinol therapy, the patient developed signs and symptoms of toxic epidermal necrolysis that included pseudomembranous conjunctivitis with ulcerative lesions on the lids and conjunctiva, and punctate corneal staining with subsequent corneal abrasions. Treatment with topical antibiotics and artificial tears relieved the symptoms somewhat, but punctate staining and dry eyes persisted after 14 months of follow-up. Bilateral corneal ulcers developed and necessitated conjunctival flaps in each eye. Visual acuity in each eye was 20/40. ( Arch Ophthalmol 95:1362-1364, 1977)

Topical antibiotic therapy of staphylococcal keratitis.

Abstract: • The in vivo antibacterial effectiveness in the rabbit cornea of a number of commercially available ophthalmic antibiotic preparations was determined against a single strain of penicillinaseproducing Staphylococcus aureus isolated from a human corneal ulcer Each antibiotic was Instilled topically at hourly intervals, and the number of residual viable organisms in the cornea subsequently was ascertained In vivo measurements demonstrated that five antibiotics—neomycin sulfate, gentamicin sulfate, erythromycin, tetracycline hydrochloride, and chlortetracycline hydrochloride—were equally effective in suppressing growth of the strain of S aureus studied Therapeutic results were the same whether the corneal epithelium was present or absent for each of the drugs studied With one exception (chloramphenicol), there was excellent correlation between in vivo and in vitro findings ( Arch Ophthalmol 95:1634-1637, 1977)

The use of hydrophilic contact lenses in corneal diseases of the dog and cat: a preliminary report.

Abstract: Two types of hydrophilic contact lenses were tested in dogs and cats as part of the therapeutic regime of recurrent corneal erosions, superficial corneal ulcers and keratoconjunctivitis sicca. It was found that the lenses are well tolerated by these species when properly fitted to the cornea. If the lenses were not properly fitted, they were lost before their therapeutic effectiveness could be evaluated. The use of hydrophilic contact lenses appeared to be beneficial in the treatment of superificial corneal ulcers and recurrent corneal erosions in the dog and cat, but ineffective in the treatment of keratoconjunctivitis sicca.

Corneal perforation in Wegener's granulomatosis treated with corneal transplantation: case report.

Abstract: A 46-year-old man with Wegener's granulomatosis developed corneal ulceration and descemetocele. He was treated with a penetrating keratoplasty which has remained clear for 22 months. With the increased life expectancy of this disease corneal rehabilitation is increasingly important and possible.

Marginal corneal ulcer due to beta-streptococcus.

Abstract: • A 72-year-old woman with a lowgrade nasolacrimal duct obstruction developed a hyperacute conjunctivitis caused by β-hemolytic streptococci. This condition has been termed "conjunctivitis of Morax." An unusual feature consisting of a large, marginal furrow-like corneal ulcer was noted associated with a plastic iritis. The condition improved with the use of topical erythromycin, irrigation of the lacrimal sac with aqueous penicillin and oral penicillin. We believe that the marginal corneal ulcer was an actual infection of the corneal stroma resulting from the intense conjunctival chemosis trapping the exudate between the conjunctiva and the corneal epithelium, thus causing a breakdown of the corneal epithelium and allowing the organism to gain access to the stroma. Conjunctivitis of Morax can be clinically differentiated from a conjunctivitis associated with pneumococcal dacryocystitis and from the acute and hyperacute purulent conjunctivitis due to infection withNeisseria. (Arch Ophthalmol95:454-455, 1977)

[Mykosis of soft contact lenses (author's transl)].

Abstract: A 63-year-old patient suffering from old sclerokeratitis was fitted with a therapeutic soft contact lens one and a half years after corneal transplantation and half a year after cataract surgery. The patient was on oral and local cortisone treatment. The first three months were uneventful with an aphakic high water content lens worn continuously. This lens was lost and she was given a B-L plano T. One month later the patient was admitted to the hospital with a red eye and a large corneal ulcer. Two white spots were noted on the contact lens. In a frozen section yeast-like structures were seen on the lens that partly invaded the lens material. Fungal culture from the other deposit revealed candida tropicalis and fusarium. The corneal ulcer healed with antimycotic therapy. The possible relationship between cortisone treatment, corneal ulcer and fungal contamination of the lens is discussed.

Penicillamine in corneal ulceration.

Abstract: The cornea is a complex multilayered structure whose optical clarity depends on the precise arrangement of the constituent parts. Beneath the surface epithelium lies the main bulk of the cornea, which is composed of collagen fibrils in a surrounding protective matrix of proteoglycan and structural glycoproteins. The collagen comprises 60% of the dry weight of the cornea, and it has been shown that in certain conditions associated with loss of corneal substance, the collagen is attacked by a variety of enzymes, loosely called collagenases. Since Gross & Lapiere (1962) first reported their series of studies showing that collagenolytic enzymes were present in tissues and could work at physiological pHs, a number of authors have shown that it was possible to inhibit lysis of collagen with substances such as sodium edetate in an experimental model using tissue cultures of epithelial and stromal explants on collagen substrates. Brown et al. (1969) first showed that the ulcerated tissue of alkali-burned cornet had considerable collagenolytic activity, and by perfusing alkali-burned rabbit cornea twice daily with cysteine and sodium edetate they were able to reduce ulceration by 70 %. However, these chemicals, particularly sodium edetate, produced considerable conjunctival irritation. Subsequent studies by Itoi et al. (1969) showed that there was no inhibition of collagenase activity using cysteine at levels below those toxic to the epithelium. Brown & Weller (1970) showed in human studies that cysteine was effective in preventing corneal ulceration in 80% of alkali-burned eyes and sodium edetate in 35%, and that sodium calcium edetate was quite ineffective. The mechanism of inhibition of collagenase was shown to be related partly to chelation of metallic ions, including calcium and zinc, such inhibition being reversible on addition of higher concentrations of the necessary ions, but also partly irreversible, resulting from reduction of disulphide bonds in collagenase with subsequent binding to the SH site liberated. More recent studies have shown the importance of stromal proteoglycans in alkali burns and the early loss of these substances when corneal pathological changes ensue. Furthermore, crude preparations of corneal proteoglycans were shown to inhibit collagenase, although purified preparations of heparin, chondroitin sulphate and keratan sulphate were ineffective. Francois et al. (1973) published findings in the treatment of various types of corneal pathological changes using penicillamine, and we wish to report here our experience using this compound in the treatment of experimentally induced alkali burns in rabbits, and also in the treatment of Mooren's ulceration in human subjects.