TREATMENT OF ADENOVIRAL KERATITIS DISEASE USING SMILE MODULE

Published 2023 - 27th ESCRS Winter Meeting

Reference: CR06 | Type: Case Report (Cornea Day) | DOI: 10.82333/fxg0-r166

Authors: Njomza Hima Musa ¹ , Faruk Semiz* ¹ , Anita Syla Lokaj ¹ , Olcay Semiz ¹ , Ceren Ece Semiz ¹ , Zekeriya Alp Demirsoy ¹

¹Ophthalmology,Eye Hospital,Pristina,Kosovo

Purpose

Brief Summary:

Adenoviral keratitis (caused by adenovirus) is one of the most frequently diagnosed eye diseases. Most of these infections have symptoms like Ocular itchiness and irritation, chemosis (conjunctival edema), photophobia, epiphora, foreign body sensation etc.

Adenoviral subepithelial infiltration is one of the most challenging complications to treat

Our purpose is to evaluate corneal transparency, recurrence, and visual acuity in patients with adenoviral subepithelial infiltration by first removing the infiltrative stroma with a SMILE and implanting the same volume of fresh lenticule in the prepared stromal pocket.

Setting

Department of Ophthalmology Eye Hospital Prishtina Kosova

Report of case

Between 2018 and 2019, a 25-year-old female patient, who was dissatisfied despite long-term medical treatment in various hospitals (antiviral drugs, topical corticosteroids eyedrops, compresses, artificial tears, and topical cycloplegic), had subepithelial infiltration in the cornea of right eye OD UDVA =.0,1, and CDVA =0.4 (-2.50 D),TOD 14mmHg, before the operation.In Left eye OS cornea is transparent and UDVA =0.2, CDVA=1.0 (-1.75 D) TOS 16mmHg.

In OCT, firstly, the thickness of the adenoviral subepithelial infiltration in the cornea was calculated as microns, and accordingly, Small Incision Lenticule Extraction (SMILE) -3.50D and -1.0 D fresh lenticule was implanted.

Result

The patient was followed for one year. No complications were observed in the patient. After the surgery, there was an increase in satisfaction and vision. She returned to her daily life very quickly.

Postoperatively,OD UDVA was 0.8, cornea clear.

Keywords: SMILE ,adenoviral keratitis,telocytes,stem cell,keratocytes

Conclusion / Take home message

Fresh Lenticule contains live stem cells and telocytes that produce keratocytes, collagen fibers, and an extracellular matrix that contribute to the cornea's regeneration. All of these increase corneal transparency and visual acuity in patients with adenoviral keratitis.