Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review of 100 patients who underwent penetrating keratoplasty revealed 47 who required therapeutic soft contact lenses in the early postoperative period. Twelve corneal ulcer-infiltrates, 11 of which were culture positive, occurred during soft contact lens wear (23% incidence of this complication in contact lens fitted eyes). The most common offending organism was coagulase-negative staphylococcus. The only statistically significant risk factor for infection if a lens was used was the presence of a persistent epithelial defect (p = 0.03). Factors which could not be statistically correlated with corneal ulcer-infiltrate included keratoconjunctivitis sicca, the type of contact lens, the method of donor cornea preservation, lens hygiene, antibiotic and steroid usage, the presence of blepharitis, preoperative bacterial keratitis, and the history of a previously failed penetrating keratoplasty.
Cornea 1984
PMID:Corneal ulcer-infiltrate associated with soft contact lens use following penetrating keratoplasty. 639 34

Six cases are described of Pseudomonas aeruginosa ulcerative keratitis in which antibiotic sensitivity studies demonstrate organism resistance to gentamicin sulfate but sensitivity to other aminoglycosides such as tobramycin and amikacin. In four cases, community-acquired infections represent the source of these ulcers. This paper documents the emergence of aminoglycoside resistance among Pseudomonas aeruginosa keratitis within the general community.
Cornea 1984
PMID:Gentamicin-resistant Pseudomonas aeruginosa corneal ulcers. 644 74

The comparative corneal epithelial effects of rigid gas permeable and soft contact lenses are reported in the present preliminary study using two bush baby monkeys (Galago senegalensis). Both types of lenses produced early cell death among the surface squamous cells while internally the epithelium and its nerve fibers remained normal. Sporadically small abnormal groups of cells involving two to three of the surface layers were observed in both the hard and soft lens wearing corneas. It was concluded that this represented superficial punctate keratitis (SPK). Small superficial intracellular epithelial cysts with membranous contents were infrequently noted in the gas permeable lens wearing cornea and it is suggested here that they were mild forms or precursors of those seen clinically in human corneas. Since the gas permeable lens met the corneal oxygen requirement it is postulated that the traumatic effect of the rigidity of the lens caused the cystic formation to occur. The relative hypoxia induced by the soft contact lens resulted in a mild superficial epithelial edema.
Cornea 1984
PMID:Corneal epithelial response of the primate eye to gas permeable corneal contact lenses: a preliminary report. 653 28

The treatment of herpes simplex keratitis has ranged from simple debridement to the use of prototypic antiviral agents specific to the herpes family, such as acyclovir. The various treatment modalities for dendritic keratitis, for the most part, have been effective. However, in recent years numerous reports of antiviral-resistant strains of herpes simplex have appeared, particularly in immunocompromised patients receiving chronic acyclovir. Interferon has been proposed as a possible treatment adjunct in these cases. We report the case of a 46-year-old man on chronic immunosuppressive and acyclovir therapy after a renal transplant who developed ulcerative keratitis due to a strain of herpes simplex virus that was resistant to multiple antiviral agents both in vivo and in vitro. After 7 weeks without improvement on multiple treatment regimens, including trifluridine, vidarabine, debridement, and topical and systemic acyclovir, interferon alpha-2a was added to topical acyclovir therapy, and the keratitis quickly resolved. Topical interferon alpha-2a appears to be an effective treatment adjunct for refractory herpes simplex keratitis in patients with cell-mediated immune dysfunction and subsequent lack of endogenous interferon. Its value in nonimmunocompromised patients remains to be determined.
Cornea 1995 May
PMID:Topical interferon alpha-2a treatment of herpes simplex keratitis resistant to multiple antiviral medications in an immunosuppressed patient. 760 Aug 20

Because contact lens wear causes changes in tear film and corneal metabolism and can render the cornea susceptible to bacterial invasion, we examined the role of contact lens wear in Pseudomonas aeruginosa (P. aeruginosa) keratitis and its relation to the early defense mechanism, specifically whether the acute polymorphonuclear leukocyte (PMN) response is altered by contact lens wear. Thirty-three rabbit eyes were examined in an experimental model for P. aeruginosa keratitis. The development of bacterial invasion and PMN migration into the wound was studied during various time intervals in either the presence or absence of a soft hydrogel contact lens (SCL). Scanning electron microscopy revealed massive PMN accumulation in the P. aeruginosa-inoculated corneas without SCL and some, but distinctively fewer, PMNs in the bacteria-inoculated eyes with SCL. These observations demonstrate that P. aeruginosa inoculation evokes massive PMN reaction and suggests that SCL wear actually delays this early host inflammatory response. Thus, SCL wear seems to act as a barrier for the PMNs that presumably derive from the tear film.
Cornea 1995 Jul
PMID:Scanning electron microscopy of the early host inflammatory response in experimental Pseudomonas keratitis and contact lens wear. 767 6

A prospective comparative evaluation of Bard Parker blade no. 15 and calcium alginate swab in the collection of corneal material was conducted. The study group included 30 consecutive cases of bacterial (n = 17), fungal (n = 11), and mixed (n = 2) cases of microbial keratitis. The samples collected by blade and swab were processed in an identical manner for viable colony counts. The yields from blade and swab were compared using the proportion test, taking into consideration the mean counts of each organism. The swab yielded significantly greater growth than blade (p = 0.003) in mycotic ulcers. However, the two patients (2/11) who showed no growth by blade but were positive by swab had smears positive and were diagnosed as mycotic ulcers. The difference between the two methods was not significant for bacterial and mixed ulcers. Replacement of blade with calcium alginate swab did not appear to be advantageous for the investigation of infectious keratitis.
Cornea 1995 Jul
PMID:Calcium alginate swab versus Bard Parker blade in the diagnosis of microbial keratitis. 767 7

The effect of poloxamer 407 on Pseudomonas aeruginosa adherence to cultured epithelial cells from rabbit corneas was investigated. Three methods of bacterial quantification were used to assess P. aeruginosa adherence: scanning electron microscopy (SEM) counts, radioactivity counts, and viable bacteria counts. Confluent monolayers of rabbit corneal epithelial cells were incubated in agitation for 30 min at room temperature with H3-labeled or nonradiolabeled P. aeruginosa (10(10) bacteria/ml) in a solution of poloxamer 407 [2% or 4% in phosphate-buffered saline (PBS)] or PBS as control. Cell monolayers were washed to remove nonadherent bacteria and fixed with 2.5% glutaraldehyde and processed for SEM or processed for radioactivity counting or for culture on agar plates. The results showed that both solutions of poloxamer 407 inhibited approximately 75% of the bacterial adherence to epithelial cells (p < 0.05). Similar percentages of bacterial inhibition were obtained using the three methods of bacterial quantification. The use of an antiadherent agent such as poloxamer 407 in eye drops could possibly be a prophylactic approach to P. aeruginosa keratitis.
Cornea 1995 Jan
PMID:Effect of poloxamer 407 on the adherence of Pseudomonas aeruginosa to corneal epithelial cells. 771 38

We report an outbreak of 43 episodes of presumed microbial keratitis in 42 disposable soft contact lens wearers seen in the Accident Room of Manchester Royal Eye Hospital during a period of 20 months, and compare this with the general incidence of contact lens-related corneal infection found in a retrospective survey of 6 months' Accident Room attendances during the same period. Thirty-seven patients had worn Acuvue lenses, three had worn Nuvue, and there was no record in two cases. Corneal scrapes were taken for microbiological examination in 27 patients, and 6 of these were culture positive. Conjunctival swabs were taken from eight eyes and one was culture positive. The contact lenses of 11 patients were sent for culture and all grew pathogenic organisms. Pseudomonas spp. were the most common organisms grown, having been found in three of six corneal scrapes and six of 11 contact lens cultures. All affected eyes responded promptly to cessation of contact lens wear and topical antibiotic therapy, with none sustaining severe or permanent visual loss. Reasons for the associated high risk of microbial keratitis are discussed. Thirty-three of the 42 patients responded to a questionnaire regarding lens wear and care and their responses are reported. In consequence, we consider disposable soft contact lenses to be relatively high-risk devices for the cosmetic management of simple myopia, and their continued use must be called into question.
Cornea 1995 Mar
PMID:Disposable soft contact lens ulcers: a study of 43 cases seen at Manchester Royal Eye Hospital. 774 94

Nontuberculous Mycobacterium keratitis is characterized by its indolent course and poor response to antibiotic drugs. Between November 1989 and September 1993, 10 eyes diagnosed to have nontuberculous Mycobacterium keratitis underwent therapeutic lamellar keratectomy in conjunction with fortified topical medications. Nine operated eyes (90%) recovered with a shortened course and healed with an inactive scar. Six patients (60%) achieved a visual acuity of 20/40 or better postoperatively. For recalcitrant nontuberculous Mycobacterium keratitis, therapeutic lamellar keratectomy is highly recommendable for patients with intractable paracentral or peripheral ulcer, for uncompliant patients, for patients who cannot tolerate drug-induced ocular toxicity, or when penetrating keratoplasty is to be reserved for late rehabilitation of the eye.
Cornea 1995 Mar
PMID:Therapeutic lamellar keratectomy in the management of nontuberculous Mycobacterium keratitis refractory to medical treatments. 774 99

The authors sought to determine whether adenovirus could infect human corneal epithelium in vivo. They reviewed the medical records of six patients with adenovirus-positive viral corneal cultures who were examined at the Bascom Palmer Eye Institute between March 21, 1986, and December 31, 1992. The six patients with adenovirus-positive viral corneal cultures included one patient with dendritic epithelial keratitis, one with geographic epithelial ulceration, three with both geographic ulceration and contiguous dendrites, and one with heaped-up corneal epithelium but no ulceration. Four patients had rose bengal solution applied to their ocular surface, and in all four patients rose bengal uptake was seen at the epithelial edges of the dendrite or geographic ulceration in a manner characteristic of herpes simplex viral keratitis. Serotype determination of the isolates showed adenovirus type 3 (one patient), type 8 (three patients), type 19 (one patient), and indeterminate (one patient). Results of monoclonal antibody staining of cultures against herpes simplex virus (types 1 and 2) antigens was negative for all six cases. Adenovirus epithelial keratitis may result from infection of human corneal epithelium by the virus and rarely may mimic infection of corneal epithelium by herpes simplex virus.
Cornea 1995 Mar
PMID:Adenovirus epithelial keratitis. 774


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