Rao S K, Biswas J, Rajagopal R, Sitalakshmi G, Padmanabhan P
Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India. MDSAAA35giasmd01.vsnl.net.in.
Int Ophthalmol. 1998;22(4):201-6. doi: 10.1023/a:1006256114463.
The clinical, histopathologic features, and treatment outcomes in 3 patients with ligneous conjunctivitis are described. Bilateral, idiopathic membranes occurred in the palpebral conjunctiva in 2 patients. In 1 patient, unilateral conjunctival changes occurred in the bulbar conjunctiva, at the site of pterygium excision. Treatment included topical hyaluronidase, chymotrypsin, heparin, and cyclosporine and surgical excision with limited or no success. In one patient, conjunctival autografting from the normal fellow eye resulted in pseudomembrane formation at the donor site in the previously unaffected eye. Histopathological evaluation of excised membranes revealed the presence of amorphous eosinophilic hyaline material and chronic inflammatory cells. Immunohistochemical study revealed a predominance of T-lymphocytes. This case series confirms the recalcitrant clinical course of ligneous conjunctivitis. Conventional treatment modalities described in literature were not useful in the management of this condition. Surgical manipulation of the unaffected fellow eye in patients with unilateral disease can result in pathologic conjunctival changes, and is best avoided.
描述了3例木样结膜炎患者的临床、组织病理学特征及治疗结果。2例患者睑结膜出现双侧特发性膜。1例患者在翼状胬肉切除部位的球结膜出现单侧结膜改变。治疗包括局部应用透明质酸酶、糜蛋白酶、肝素和环孢素以及手术切除，但效果有限或无效。1例患者从正常对侧眼进行结膜自体移植，导致先前未受影响的眼的供体部位形成假膜。切除膜的组织病理学评估显示存在无定形嗜酸性透明物质和慢性炎症细胞。免疫组织化学研究显示T淋巴细胞占主导。该病例系列证实了木样结膜炎顽固的临床病程。文献中描述的传统治疗方法对这种疾病的治疗无效。单侧疾病患者对未受影响的对侧眼进行手术操作可导致病理性结膜改变，最好避免。
