Fukuda K, Takeuchi H, Nishida T
Department of Ophthalmology, Yamaguchi University School of Medicine, Yamaguchi, Japan.
Jpn J Ophthalmol. 2000 Sep-Oct;44(5):520-3. doi: 10.1016/s0021-5155(00)00209-4.
Corticosteroids seem to affect the functions of corneal endothelial cells directly in addition to their anti-inflammatory effect.
A 69-year-old man presented with blurred vision in his left eye and decreased visual acuity in both eyes. He had received anterior-posterior radial keratotomy for myopia in both eyes 40 years earlier.
Both eyes showed mild corneal stromal edema in the pupil area. We diagnosed the condition as corneal edema secondary to cell loss and dysfunction of corneal endothelium after surgery. One month later, the stromal edema was further advanced in the left eye. Corneal thickness had increased from the initial value of 619 microm to 631 microm, and corrected visual acuity had decreased from 0.5 to 0.06. There were no signs suggesting inflammatory reaction. The left eye was then treated with topical corticosteroid eyedrops and subconjunctival corticosteroid injection. Two months later, corneal thickness had decreased to 546 microm and visual acuity had improved to 0.5.
This case shows that topical corticosteroids may be effective in treating corneal edema by producing an anti-inflammatory effect and possibly activating the endothelium.
皮质类固醇除具有抗炎作用外，似乎还能直接影响角膜内皮细胞的功能。
一名69岁男性，左眼视力模糊，双眼视力下降。40年前他双眼接受了放射状角膜切开术治疗近视。
双眼瞳孔区角膜基质轻度水肿。我们将该病症诊断为手术后角膜内皮细胞丢失和功能障碍继发的角膜水肿。1个月后，左眼基质水肿进一步加重。角膜厚度从最初的619微米增加到631微米，矫正视力从0.5下降到0.06。没有炎症反应的迹象。随后对左眼进行局部皮质类固醇滴眼液和结膜下皮质类固醇注射治疗。2个月后，角膜厚度降至546微米，视力提高到0.5。
该病例表明，局部皮质类固醇可能通过产生抗炎作用并可能激活内皮细胞来有效治疗角膜水肿。
