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All Journal Journal of Tropical Life Science : International Journal of Theoretical, Experimental, and Applied Life Sciences Jurnal Kedokteran Brawijaya MNJ (Malang Neurology Journal) Majalah Kesehatan FKUB JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Pediatric Sciences Journal Vision Science and Eye Health Journal IJRETINA - International Journal of Retina Ophthalmologica Indonesiana
Lely Retno W
Department Of Ophthalmology, Universitas Brawijaya, Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Vision Science and Eye Health Journal

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A Challenging Management of Pseudomonas Perforated Corneal Ulcer with Multilayer Amniotic Membrane Transplantation and Pericardial Patch Graft in Pediatric Patient Nabilah Afifah; Herwindo Dicky Putranto; Lely Retno Wulandari
Vision Science and Eye Health Journal Vol. 1 No. 1 (2021): Vision Science and Eye Health Journal
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (975.131 KB) | DOI: 10.20473/vsehj.v1i1.2021.22-27

Abstract

Introduction: Pseudomonas aeruginosa (P. aeruginosa) is the leading cause of corneal ulcers in children 0 to 3 years of age compared to children in general. Case presentation: A two-months-old infant presented with whitish patches on the right eye two days before admission. A central corneal ulcer with a size of 7-mm x 7-mm accompanied by corneal thinning and melting was shown on the right cornea. It is was surrounded by greyish white creamy infiltrates. Corneal scraping showed Pseudomonas aeruginosa specimens. The cornea became perforate and crystalline lens extrusion was found at the day after intravenous ceftriaxone, levofloxacin eye drop, and cefazoline fortified eye drop administering. It might be caused by bacterial elastase and toxin which contributed to corneal damage. The patient was underwent a multilayer Amniotic Membrane Transplantation (AMT) combined with a pericardial patch graft due to corneal perforation. Two months post-AMT and pericardial patch graft the corneal perforation became entirely heal due to multilayer AMT, despite lysis of the pericardial patch graft. Corneal scar formation and reduction of vitreous opacity in ultrasound examination were shown. The patient was planned to undergo keratoplasty. Conclusions: Corneal ulcers due to Pseudomonas aeruginosa are highly destructive. The levels of infection, diagnostic, and therapeutic are still problems in pediatric patients. Lens extrusion and lysis of the pericardial patch graft are examples in this case. Keratoplasty is the definitive treatment for corneal ulcers with perforation; however, multilayer AMT combined with pericardial patch graft can be used as an alternative therapy to accelerate wound healing, reduce inflammation, and maintain the integrity of the eyeball.
Co-Authors Abdullah, Aulia Abdul Hamid Anny Sulistiyowati Aulia Rachma Nur Azizah Cahya, Srestha Indra Effendi, Ma'sum Fariz Nufiarwan Hanik Badriyah Hidayati,* Mohammad Hasan Machfoed,* Kuntoro,** Soetojo,*** Budi Santoso,**** Suroto,***** Budi Utomo****** Hardian Wicaksono Hariwati Hariwati Herdita, Zahra Naura Herwindo Dicky Putranto Hidayat Sujuti Hidayat Sujuti Hidayat Suyuti Indri Wahyuni Indriaswati, Dyah Kusworini Joni Susanto, Joni Karim, Muhammad Rico Abdul Koentartiwi, Dyahris Kristina Radika HK Ma'sum Effendi Marzuqi, Ahmad Azhar Nabilah Afifah Nadia Artha Dewi Onassis, Marvel Prastyani, Reni Risnanda, Muhammad Rafi Rizqillah, Aliyah Faiza Rofa Husnul Khuluqi Rozalina Loebis Rozalina Loebis, Rozalina Safaruddin Refa Susanto Nugroho Syarifah Rohaya Tjujitno, Aurellia Valmai Vierlia, Wino Vrieda Wahyu Anandita, Nanda Wino Vrieda Vierlia Yunneke Renna Xaverina Yurike Mandrasari