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Successful Treatment of Infectious Scleritis by Pseudomonas aeruginosa with Autologous Perichondrium Graft of Conchal Cartilage.

Abstract
Infectious scleritis by Pseudomonas aeruginosa is a well-known vision-threatening disease. In particular, scleral trauma following pterygium surgery may increase the risk of sclera inflammation. Surgical debridement and repair is necessary in patients who do not respond to medical treatments, such as topical and intravenous antibiotics. We reports herein the effectiveness of an autologous perichondrium conchal cartilage graft for infectious scleritis caused by Pseudomonas aeruginosa. This procedure was performed on four eyes of four patients with infectious scleritis who had previously undergone pterygium surgery at Gyeongsang National University Hospital (GNUH), Jinju, Korea from December 2011 to May 2012. Pseudomonas aeruginosa was identified in cultures of necrotic scleral lesion before surgery. The conchal cartilage perichondrium graft was transplanted, and a conjunctival flap was created on the scleral lesion. The autologous perichondrium conchal cartilage graft was successful and visual outcome was stable in all patients, with no reports of graft failure or infection recurrence. In conclusion, autologous perichondrium conchal cartilage graft may be effective in surgical management of Pseudomonal infectious scleritis when non-surgical medical treatment is ineffective. Further studies in larger, diverse populations are warranted to establish the effectiveness of the procedure.
AuthorsWoong Sun Yoo, Che Ron Kim, Byung Jae Kim, Seong Ki Ahn, Seong Wook Seo, Ji Myong Yoo, Seong Jae Kim
JournalYonsei medical journal (Yonsei Med J) Vol. 56 Issue 6 Pg. 1738-41 (Nov 2015) ISSN: 1976-2437 [Electronic] Korea (South)
PMID26446662 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
Topics
  • Anti-Bacterial Agents (therapeutic use)
  • Autografts
  • Cartilage (surgery)
  • Communicable Diseases
  • Debridement
  • Eye Infections, Bacterial (etiology, therapy)
  • Female
  • Humans
  • Ophthalmologic Surgical Procedures
  • Postoperative Complications
  • Pseudomonas Infections (microbiology, therapy)
  • Pseudomonas aeruginosa (isolation & purification)
  • Pterygium (surgery)
  • Republic of Korea
  • Sclera (surgery, transplantation)
  • Scleritis (microbiology, therapy)
  • Surgical Wound Infection (microbiology, therapy)
  • Transplantation, Autologous
  • Treatment Outcome

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