Main Article Content
To report a case series of refractory filamentary keratitis successfully managed with sutureless amniotic membranes resistant to other management strategies.
Three cases are discussed with anterior segment photography who were diagnosed with filamentary keratitis and successfully managed with sutureless amniotic membranes, after experiencing limited relief with standard treatments.
This case series demonstrates the complex management of patients with filamentary keratitis who had failed with traditional therapies and were successfully managed with sutureless amniotic membranes. All three patients demonstrated improvement in both ocular signs and symptoms following amniotic membrane application to the ocular surface.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Copyright of articles published in all DPG titles is retained by the author(s). The author(s) grants DPG the rights to publish the article and identify itself as the original publisher. The author grants DPG exclusive commercial rights to the article. The author grants any party the rights to use the article freely for non-commercial purposes provided that the original work is properly cited.
2. Read SP, et al. Treatment of refractory filamentary keratitis with autologous serum tears. Eye Contact Lens 2017;43(5):e16–e18.
3. Albietz JM and Bruce AS. The conjunctival epithelium in dry eye subtypes: effect of preserved and non-preserved topical treatments. Curr Eye Res 2001;22(1):8–18.
4. Albietz J, et al. Management of filamentary keratitis associated with aqueous-deficient dry eye. Optom Vis Sci 2003;80(6):420–30.
5. Gumus K, et al., Botulinum toxin injection for the management of refractory filamentary keratitis. Arch Ophthalmo 2012;130(4):446–50.
6. Tanioka H, et al., Investigation of the corneal filament in filamentary keratitis. Invest Ophthalmol Vis Sci 2009;50(8):3696–702.
7. Bron AJ, et al. TFOS DEWS II pathophysiology report. Ocul Surf 2017;15(3):438–510.
8. Konomi K, et al. Preoperative characteristics and a potential mechanism of chronic dry eye after LASIK. Invest Ophthalmol Vis Sci 2008;49(1):168–74.
9. Zaidman GW, et al. The histopathology of filamentary keratitis. Arch Ophthalmol 1985;103(8):1178–81.
10. Kakizaki H, et al., Filamentary keratitis improved by blepharoptosis surgery: two cases. Acta Ophthalmol Scand 2003;81(6):669–71.
11. Kowalik BM and Rakes JA. Filamentary keratitis--the clinical challenges. J Am Optom Assoc 1991;62(3):200–4.
12. Cher I. Blink-related microtrauma: when the ocular surface harms itself. Clin Exp Ophthalmol 2003;31(3):183–90.
13. Jones L, et al. TFOS DEWS II Management and Therapy Report. Ocul Surf 2017;15(3):575–628.
14. Marsh P and Pflugfelder SC. Topical nonpreserved methylprednisolone therapy for keratoconjunctivitis sicca in Sjogren syndrome. Ophthalmology 1999;106(4):811–6.
15. Perry HD, et al. Topical cyclosporine A 0.5% as a possible new treatment for superior limbic keratoconjunctivitis. Ophthalmology 2003;110(8):1578–81.
16. Grinbaum A, Yassur I, and Avni I. The beneficial effect of diclofenac sodium in the treatment of filamentary keratitis. Arch Ophthalmol 2001;119(6):926–7.
17. Fraunfelder FT, Wright P and Tripathi RC. Corneal mucus plaques. Am J Ophthalmol 1977;83(2):191–7.
18. Bloomfield SE, et al. Treatment of filamentary keratitis with the soft contact lens. Am J Ophthalmol 1973;76(6):978–80.
19. Quinto GG, Campos M, and Behrens A. Autologous serum for ocular surface diseases. Arq Bras Oftalmol 2008;71(6 Suppl):47–54.
20. Celebi AR, Ulusoy C, and Mirza GE. The efficacy of autologous serum eye drops for severe dry eye syndrome: a randomized double-blind crossover study. Graefes Arch Clin Exp Ophthalmol 2014;252(4):619–26.
21. de Paiva A, et al. Functional repair of motor endplates after botulinum neurotoxin type A poisoning: biphasic switch of synaptic activity between nerve sprouts and their parent terminals. Proc Natl Acad Sci U S A 1999;96(6):3200–5.
22. Cheng AM, et al. Accelerated restoration of ocular surface health in dry eye disease by self-retained cryopreserved amniotic membrane. Ocul Surf 2016;14(1):56–63.
23. Suri K, et al. Sutureless amniotic membrane ProKera for ocular surface disorders: short-term results. Eye Contact Lens 2013;39(5):341–7.
24. Talmi YP, et al. Antibacterial properties of human amniotic membranes. Placenta 1991;12(3):285–8.
25. John T, et al. Corneal nerve regeneration after self-retained cryopreserved amniotic membrane in dry eye disease. J Ophthalmol 2017;2017:6404918.
26. Lambiase A, Sacchetti M, and Bonini S. Nerve growth factor therapy for corneal disease. Curr Opin Ophthalmol 2012;23(4):296–302.
27. Labbe A, et al. Corneal nerve structure and function in patients with non-sjogren dry eye: clinical correlations. Invest Ophthalmol Vis Sci 2013;54(8):5144–50.
28. McDonald MB, et al. Treatment outcomes in the DRy Eye Amniotic Membrane (DREAM) study. Clin Ophthalmol 2018;12:677–81.