Heinz Carsten, Eckstein Anja, Steuhl Klaus-Peter, Meller Daniel
Department of Ophthalmology, University of Essen, Hufelandstr. 55, 45122 Essen, Germany.
Cornea. 2004 Jul;23(5):524-6. doi: 10.1097/01.ico.0000114128.63670.e2.
To report one case of corneal ulceration associated with a severe manifestation of Graves ophthalmopathy that was treated with amniotic membrane (AM) transplantation using the inlay and overlay technique.
Case report.
A 40-year-old woman with Graves ophthalmopathy had a corneal ulcer on the left eye refractory to topical treatment and orbital decompression surgery. Severe Graves ophthalmopathy was characterized by tear film instability, lagophthalmus, and reduced Bell phenomenon. After amniotic membrane transplantation the epithelial and stromal defect healed quickly with improvement of visual acuity and within the dissolution period of the overlay AM.
Amniotic membrane transplantation is a successful and alternative approach to treat severe corneal surface disorders refractory to medical treatment in patients with Graves ophthalmopathy. Besides having an anti-inflammatory action mechanism, the overlay AM used herein as a temporary patch was possibly functioning as a protective shield to ensure epithelialization of the AM used as a graft in the ulcer bed.
报告1例与Graves眼病严重表现相关的角膜溃疡病例,该病例采用羊膜(AM)镶嵌和覆盖技术进行移植治疗。
病例报告。
一名患有Graves眼病的40岁女性左眼出现角膜溃疡,局部治疗和眼眶减压手术均无效。严重的Graves眼病表现为泪膜不稳定、眼睑闭合不全和贝尔现象减弱。羊膜移植后,上皮和基质缺损迅速愈合,视力改善,且在覆盖AM溶解期内愈合。
羊膜移植是治疗Graves眼病患者药物治疗无效的严重角膜表面疾病的一种成功且可替代的方法。除了具有抗炎作用机制外,本文用作临时贴片的覆盖AM可能起到了保护屏障的作用,以确保用作溃疡床移植物的AM上皮化。