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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

Purpose:

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

Setting:

S.Malayan's Eye Center, Yerevan, Armenia

Methods:

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

Results:

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.

Conclusions:

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.

Financial Disclosure:

NONE

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