Oftalʹmologiâ (Jul 2017)

THE ROLE OF MICROTRAUMA IN THE DEVELOPMENT OF BACTERIAL CORNEAL ULCERS

  • A. I. Hazamova,
  • E. N. Verigo,
  • E. V. Chentsova

DOI
https://doi.org/10.18008/1816-5095-2017-2-136-140
Journal volume & issue
Vol. 14, no. 2
pp. 136 – 140

Abstract

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Purpose: To study the role of corneal microtrauma in the development of complications, leading to bacterial ulcers. Performed clinical assessment, conservative therapy, and surgical interventions for 236 patients with the complication of microtrauma, mainly related to the prolonged presence of foreign bodies in the cornea (86.1% they had a metallic nature). Methods included ophthalmologic investigations and laboratory procedures, which revealed the presence of bacterial corneal ulcer in 97 cases (41.1%), recurrent erosion — 62 cases (26.3%), traumatic keratitis — 25 cases (10.6%) and deep cornea’s infiltrate — 52 cases (22.0%). The development of complications was due to the later removal of FB (in some cases more than 1 month after the trauma), incomplete removal of foreign bodies, non-compliance with aseptic and antiseptic rules during in the removal of FB’s without follow up of patients. Streptococcus, staphylococcus, pneumococcus, and isolated cases of Pseudomonas aeruginosa and Escherichia coli were mainly diagnosed. Conservative therapy included specific, pathogenetic, symptomatic and antiallergic medications. Nitric oxide (NO) in the gas stream was used to accelerate the reparative processes, weakening of the inflammatory exudation and cellular proliferation. Surgical interventions were performed for preserving of eyes, prophylactic and therapeutic purposes in the form autoconjunctiveal plast y, deep lamellar and penetrating keratoplast y (preserved and fresh corneas) and amniotic membrane transplantation. According to the results of treatment of 236 patients with the corneal erosion completed with elimination of inflammatory reaction, restoration of corneal transparency; 52 patients with corneal infiltrate -development of opacities in the stromal cornea layers; patients with keratitis –formation of corneal leucoma and 52% — keratoplast y were performed. In cases of corneal ulcer process ended with the formation of a rough leucoma in 30 patients (30.9%), surgical interventions with a partial improvement of visual function were observed in 62 patients (63.9%), the removal of the eye were done in 5 patients (5.2%).

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