Complex Approach to the Bacterial Corneal Ulcers Treatment

Purpose: Objective: to evaluate the effect of treatment of bacterial corneal ulcers of varying severity using a combination of antibacterial and corticosteroid drugs.

Material and methods. 63 patients with bacterial corneal ulcers of varying severity were treated. The study used a quantitative scale to assess the severity of corneal ulcers. Group 1 — patients with mild corneal ulcers (18 patients); Group 2 — patients with moderate corneal ulcer (17 patients); group 3 — severe corneal ulcer (11 patients); control group — patients with mild corneal ulcer (17 patients). Patients of groups 1, 2 and 3, in addition to the conventional treatment, received Dexamethasone 0.1 % — 0.3 ml in parabulbar injections from the first day of treatment for the entire treatment period. Kr). In addition to the standard ophthalmological examination, all patients were assessed for the ulcer defect using measurements on OCT-POG accessing the parameters of the diameter of the corneal ulcer (d) and the depth coefficient (Kr).

Results. The patients in the 1st group received antibacterial treatment and the addition of parabulbar injections of a corticosteroid drug (Dexamethasone). It allowed to decrease the treatment time and the period of hospitalization, promoted faster epithelialization and a reduction in the depth of the ulcer, less coarse scarring of the cornea, allowed to increase the functional results of treatment. The proposed treatment for severe corneal ulcers in 55 % of cases allows to use only conservative treatment. It is possible to obtain moderate opacity with vascularization in 60 % cases, which contributes to the preservation and/or improvement of visual acuity, despite the severity of the inflammatory process without the use of surgical intervention.

Conclusion. The proposed treatment, involving the use of the corticosteroid drug Dexamethasone 0.1 % in parabulbar injections of 0.3 ml once daily for a bacterial corneal ulcer of mild severity for, average, 15.0 ± 1.4 days, a bacterial corneal ulcer of moderate severity — 18.0 ± 1.3 days, severe bacterial corneal ulcer — 25.0 ± 4.4 days, seems to be effective if the proposed parameters of the diameter and depth of the corneal ulcer are controlled. 

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