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Peripheral ulcerative keratitis (PUK) is a destructive, inflammatory process that can lead to corneal perforation and visual loss. Successful control of PUK has been reported with conjunctival resection, cyanoacrylate adhesive, and systemic immunosuppression. Cases with impending or actual corneal perforation may require more extensive surgery, including lamellar or penetrating keratoplasty, to maintain the integrity of the globe. We report on 17 eyes of 14 patients with PUK that required tectonic keratoplasty because of progressive ulceration. Surgery with concomitant immunosuppression preserved the eyes in all but two cases, and 8 of 17 eyes maintained or improved preoperative visual acuity. Six eyes had final visual acuities of 20/200 or better. This therapeutic strategy can preserve eyes that might otherwise be lost to progressive inflammation.

To compare the corneal and aqueous penetration and pharmacokinetics of gatifloxacin 0.3% and moxifloxacin 0.5% ophthalmic solutions and their effect on corneal reepithelialization after penetrating keratoplasty.In this randomized, open-label, parallel-controlled study, corneal and aqueous penetration and the pharmacokinetic parameters of topically applied gatifloxacin 0.3% and moxifloxacin 0.5% (2 preoperative doses of 1 drop given 5 minutes apart) were estimated by using a sparse sampling method. Corneal and aqueous samples were collected 0.25, 0.5, 1, or 2 hours after the final dose. The concentration was determined by a high-performance liquid chromatography method. Stromal Cmax:MBC50 (maximum drug concentration in serum to 50% minimum bactericidal concentration) ratios for selected ocular pathogens were also assessed. Postoperative corneal reepithelialization at days 1, 3, and 7 was evaluated and compared between groups.The calculated pharmacokinetic parameters were higher with moxifloxacin 0.5% than with gatifloxacin 0.3%. The stromal Cmax was 48.5 versus 15.7 microg/g (P = 0.04), and the stromal AUC0-2 (area under the concentration-time curve from 0 to 2 hours) was 30.9 versus 13.6 mug.h/g (P0.05). The endothelial Cmax was 76.1 versus 7.3 microg/g (P0.05), and the endothelial AUC0-2 was 43.9 versus 9.8 microg.h/g (P0.05). The aqueous Cmax was 0.9 versus 0.3 microg/mL (P0.05), and the aqueous AUC0-2 was 1.2 versus 0.4 microg.h/mL (P0.05). Stromal Cmax:MBC50 ratios were higher in the moxifloxacin 0.5% group for each pathogen tested. The corneal reepithelialization rates were comparable between groups.Topical preoperative moxifloxacin 0.5% achieved greater corneal and aqueous penetration than did gatifloxacin 0.3%. The clinical significance of this difference is not known. Postoperative use of these agents had similar effects on corneal reepithelialization.

A number of studies, using either rat or rabbit models, have focused on delineating the role of cell surface glycoconjugates in corneal epithelial cell migration and wound healing. We have recently identified the cell surface sialoglycoproteins of rabbit corneal epithelium and have shown that the levels of at least three membrane glycoproteins are markedly altered during cell migration. Because species-related differences may be present, it is important to select an appropriate animal model for studies designed to contribute to the understanding of the mechanism of human corneal wound healing. The purpose of this study was to identify the cell surface sialoglycoproteins of human corneal epithelium. Plasma membrane sialoglycoproteins of primary cultures of human corneal epithelium were labeled with NaB3H4 after oxidation by mild NaIO4 treatment. The labeled glycoproteins were analyzed by SDS-polyacrylamide gel electrophoresis and fluorography. Four different preparations of human corneal epithelial cell cultures were analyzed, and results were compared with those of rabbit corneal epithelium. Of the 11 radiolabeled sialoglycoproteins we identified recently in rabbit corneal epithelium, eight were also present in human corneal epithelium. These similarities in the electrophoretic patterns of the plasma membrane glycoproteins of the two species suggest that rabbit is most likely an appropriate animal model for studies designed to contribute to the understanding of the structure and function of cell surface glycoproteins of human corneal epithelium.