自身免疫性多内分泌腺病-念珠菌病-外胚层营养不良患者角膜穿孔的非手术成功治疗
Successful nonsurgical management of corneal perforation in a patient with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy.
作者信息
Yeh Steven, Matoba Alice Y
机构信息
Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA.
出版信息
Cornea. 2007 Aug;26(7):880-2. doi: 10.1097/ICO.0b013e318073c213.
PURPOSE
To describe a patient with a history of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) who has experienced two episodes of noninfectious corneal ulceration with perforation that has been successfully managed with nonsurgical therapy.
METHODS
Case report.
RESULTS
An 18-year-old male with a history of APECED has been followed up with recurrent keratoconjunctivitis and episodes of microbial keratitis since 4 years of age. Ophthalmic complications have included two episodes of sterile corneal ulceration associated with corneal perforation. These episodes of stromal ulceration associated with a flat anterior chamber were managed with a bandage contact lens, topical antibiotics, and a topical cycloplegic agent. In one instance, addition of cyclosporine led to reformation of the anterior chamber and arrest of the ulcerative process.
CONCLUSION
Sterile corneal ulceration and perforation associated with APECED may be managed medically to avoid surgical intervention, which has been reported to lead to a poor outcome.
目的
描述一名患有自身免疫性多内分泌腺病-念珠菌病-外胚层营养不良（APECED）的患者，该患者经历了两次非感染性角膜溃疡伴穿孔，通过非手术治疗成功治愈。
方法
病例报告。
结果
一名有APECED病史的18岁男性自4岁起就因复发性角结膜炎和微生物性角膜炎发作而接受随访。眼部并发症包括两次与角膜穿孔相关的无菌性角膜溃疡发作。这些与前房变平相关的基质溃疡发作通过绷带角膜接触镜、局部抗生素和局部睫状肌麻痹剂进行治疗。在其中一例中，添加环孢素导致前房重新形成并使溃疡过程停止。
结论
与APECED相关的无菌性角膜溃疡和穿孔可以通过药物治疗，以避免手术干预，据报道手术干预会导致不良后果。
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