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Our experience in the treatment of PUK-like herpetic lesions

Poster Details

First Author: D.Araks ARMENIA

Co Author(s):    A. Hovakimyan   A. Malayan   A. Davtyan   A. Hovakimyan   A. Malayan        

Abstract Details


To evaluate the efficiency of amniotic membrane transplantation in the treatment of PUK-like herpetic lesions.


S.Malayan's Eye Center, Yerevan, Armenia


In the period of 2010-2016, 395 patients with herpetic corneal diseases were observed at Cornea-Uveitis Department. Out of 395 patients 216 had epitheliali herpetic keratitis, 175 had stromal disease and 4 had herpetic endothelitis. Two patients presented with PUK-like peripheral crescent shaped ulcer and underlying stromal lyses of 90%.The clinical presentation was very similar to PUK and the patients claim having joint pain, also had h/o herpes labialis, so work-up for possible associated rheumatologic disease was performed. Patients were initially prescribed tears qid. As far as work-up was negative, PCR was performed for herpes viruses and HSV 1 DNA was revealed. Patients were started on Acyclovir pills 400mg 5 timed a day, Gancyclovir (Virgan) eye gel 5 timed a day, cycloplegic drops and tears qid. There was no improvement in 10 days, the thining got worse, so amniotic membrane trasplantation was performed immediately


The amniotic membrane got resolved within 10 days after surgery. The limbal injection dramatically subcided, the epithelial defect was almost healed and the stromal thickness was increased up to 10-20%. Eight weeks later the eyes looked almost quiet, there was no limbal injection, epithelium was intact, thinning area was improved to about 30% of thickness. Patients were left with anterior stromal scars. Patients were advised to continue Acyclovir pills more than 6 months, stay on tears for a long period.


The amniotic membrane transplantation is a very helpful procedure in cases where only antiviral treatment is insufficient and coneal perforation is threatening, which was relevant in our patients with PUK-like lesions. Patients should be continued on oral antiviral treatmnet for a long period of time.

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