Nuzzi Raffaele, Buschini Elisa
Section of Ophthalmology, Department of Clinical Pathophysiology, University of Turin, Turin, Italy.
Case Rep Ophthalmol. 2011 Apr 11;2(1):123-8. doi: 10.1159/000324750.
A 32-year-old man suffering from keratoconus was treated with radial keratotomy. Twenty weeks later, he presented visual deterioration, edema and corneal perforation. A penetrating keratoplasty was required. The postoperative course was regular, but after 9 months, the patient presented kerato-uveitis. Subsequent phlogistic relapses occurred approximately every 6 months during the following 5 years. The performed cultures were positive only during the first episode. Radial keratotomy is not indicated in keratoconus. The multiple relapses of kerato-uveitis could not be explained by infection, and we hypothesized that they may be due to a 'traumatic memory' of the cornea caused by the several suffered traumatisms, without clinical features of corneal graft rejection. The risks of new penetrating keratoplasty and cataract surgery are high. As the cornea is the tissue with the highest sensitivity in the body, we tried to explain the relapsing kerato-uveitis as a consequence of the disruption of the nervous corneal network.
一名32岁的圆锥角膜患者接受了放射状角膜切开术治疗。20周后，他出现视力下降、水肿和角膜穿孔。需要进行穿透性角膜移植术。术后过程正常，但9个月后，患者出现角膜葡萄膜炎。在接下来的5年里，炎症大约每6个月复发一次。仅在首次发作时进行的培养结果呈阳性。圆锥角膜患者不适合进行放射状角膜切开术。角膜葡萄膜炎的多次复发无法用感染来解释，我们推测它们可能是由于角膜遭受多次创伤所导致的“创伤记忆”，而没有角膜移植排斥的临床特征。再次进行穿透性角膜移植术和白内障手术的风险很高。由于角膜是人体中敏感度最高的组织，我们试图将复发性角膜葡萄膜炎解释为角膜神经网络中断的结果。
