Filamentary keratitis

A study was discontinued because an interim analysis of data revealed 4 patients with filamentary keratitis treated with 0.2% topical fluconazole (and concurrent oral fluconazole) had failed to respond to treatment (Rao et al.). 

Albietz J, Sanfilippo P, Troutbeck R, et al. Management of filamentary keratitis associated with aqueous-deficient. OptomVis Sci 2003 80 420-430. 

Patients with exposure keratopathy may develop filamentary keratitis.The dry eye can cause corneal irregularities and increased mucin, which promotes the formation of fine epithelial and mucous strands that are attached to... 

Avisar R, Robinson A, Appel I, et al. Diclofenac sodium, 0.1% (Voltaren Ophtha), versus sodium chloride, 5%, in the treatment of filamentary keratitis. Cornea 2000 19 145-147. 

Corneal involvement, in the form of superficial punctate keratopathy of the epithelium, is common and is found in 100% of patients. More serious changes include corneal ulceration, with subsequent loss of vision in 70% of patients, neovascularization, pannus, and scarring. Other corneal findings include Trantas dots, keratoconus, and filamentary keratitis. 

Two other complications now ascribed to alpha chymotrypsin are persistent iridoplegia and filamentary keratitis. In a series of 3222 operations with enzymic zonulolysis the former was observed in 18 (0.05%) and the latter in 34 (1.05%) cases (IS ). It is remarkable that both persistent iridoplegia and increased intraocular pressure developed in aU 3 patients in whom the zonula ciliaris was impregnated with an alpha chymotrypsin solution in a concentration of 1 200 instead of I 5000 as is normally used. 

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