Subpalpebral lavage antibiotic treatment for severe infectious scleritis and keratitis

Cornea. 2006 Feb;25(2):159-63. doi: 10.1097/01.ico.0000177837.31249.19.


Objective: To report the subpalpebral lavage therapy for the treatment of infectious scleritis and keratitis.

Method: Six patients were admitted for treatment of severe infectious scleritis and keratitis and were initiated on the subpalpebral lavage system after showing no improvement with topical fortified antibiotics. A continuous antibiotic lavage was applied until clinical sterility was achieved and topical steroids were gradually added to control concomitant inflammation.

Results: All 6 patients had resolution of their infections and achieved a stable ocular surface with no inflammation. One patient required a corneal transplant for active inflammation and corneal thinning, 1 had a transplant for a dense central corneal scar, and 1 patient underwent corneal transplant and cataract extraction. One case was a Pseudomonas keratitis in a blind eye, which rapidly resolved and has remained stable. Four patients required additional surgeries, which included 3 corneal transplants, 2 cataract extractions, and 1 glaucoma aqueous shunt.

Conclusion: Continuous irrigation of the eye can improve scleral penetration of antibiotics. Subpalpebral lavage provides continuous irrigation and may be effective in the treatment of infectious scleritis of a variety of etiologies.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / therapeutic use
  • Cornea / microbiology
  • Cornea / pathology
  • Eye Infections, Bacterial / drug therapy*
  • Eye Infections, Bacterial / microbiology
  • Female
  • Follow-Up Studies
  • Humans
  • Keratitis / drug therapy*
  • Keratitis / microbiology
  • Middle Aged
  • Pseudomonas Infections / drug therapy*
  • Pseudomonas Infections / microbiology
  • Pseudomonas aeruginosa / isolation & purification
  • Sclera / microbiology
  • Sclera / pathology
  • Scleritis / drug therapy*
  • Scleritis / microbiology
  • Therapeutic Irrigation


  • Anti-Bacterial Agents