胶原交联联合核黄素和 UV-A 治疗后发生的内皮细胞衰竭：病例报告并文献复习。
Endothelial failure after collagen cross-linking with riboflavin and UV-A: case report with literature review.
机构信息
Cornea and Anterior Segment Department, L.V. Prasad Eye Institute, Hyderabad, India.
出版信息
Cornea. 2012 Oct;31(10):1197-200. doi: 10.1097/ICO.0b013e31823cbeb1.
PURPOSE
To report a case of endothelial decompensation after a collagen cross-linking (CXL) procedure for keratoconus.
METHODS
An 18-year-old boy had CXL for keratoconus in the right eye. He developed keratouveitis with generalized corneal edema seen 3 weeks after the procedure. Polymerase chain reaction for aqueous humor Herpes simplex virus was negative. The patient was treated with topical steroids. Specular microscopy revealed mildly reduced density of endothelial cells. On follow-up to 6 months, corneal edema increased with the formation of epithelial bullae. Penetrating keratoplasty was performed. Possible causes for this complication are discussed.
RESULTS
Clinical and histopathological analyses revealed generalized loss of endothelial cells along with signs of inflammation.
CONCLUSIONS
Although it is considered very safe, collagen CXL can cause severe keratouveitis and endothelial failure.
目的
报告一例圆锥角膜交联（CXL）术后角膜内皮失代偿。
方法
一名 18 岁男性右眼行 CXL 治疗圆锥角膜。术后 3 周出现全层角膜水肿伴角膜葡萄膜炎。房水单纯疱疹病毒聚合酶链反应为阴性。患者接受局部皮质类固醇治疗。共焦显微镜显示内皮细胞密度轻度降低。随访 6 个月时，角膜水肿加重，形成上皮水疱。行穿透性角膜移植术。讨论了该并发症的可能原因。
结果
临床和组织病理学分析显示，内皮细胞广泛丧失，伴有炎症迹象。
结论
尽管交联胶原被认为非常安全，但仍可引起严重的角膜葡萄膜炎和内皮功能衰竭。
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