Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.
Eye Contact Lens. 2013 Nov;39(6):413-5. doi: 10.1097/ICL.0b013e3182960fdf.
To present a case of corneal ulcer unresponsive to medical treatment, successfully treated with the use of ultraviolet (UV) A and riboflavin collagen crosslinking (CXL) administered twice.
A 68-year-old diabetic male patient was diagnosed with unilateral severe corneal ulcer. Gram and Giemsa stains and corneal culture results were performed twice, but no specific pathogen could be detected. The clinical presentation suggested fungal infection. The ulcer was unresponsive to extensive medical treatment administered for 10 days. There was an initial response to topical and intrastromal voriconazole administration; however, this was followed by reactivation. Therefore, UVA-riboflavin treatment was performed when the patient was still on medical therapy.
The stromal infiltrate appeared inactive 1 week after UVA-riboflavin CXL treatment. However, reactivation was noticed on the second week, and a second UVA-riboflavin treatment was planned and performed 3 weeks after the first one. The epithelial defect disappeared, and the stromal infiltrate stayed inactive starting from the first week of the second UVA-riboflavin treatment until the last follow-up examination at month 6.
The UVA-riboflavin CXL may be considered in the management of corneal ulcers unresponsive to medical management.
介绍一例经两次紫外线（UV）A 和核黄素胶原交联（CXL）治疗成功的药物治疗无效的角膜溃疡病例。
一名 68 岁的糖尿病男性患者被诊断为单侧严重角膜溃疡。进行了两次革兰氏和吉姆萨染色和角膜培养，但未检测到特定病原体。临床表现提示真菌感染。溃疡对 10 天的广泛药物治疗无反应。局部和基质内伏立康唑治疗开始时有初步反应，但随后出现复发。因此，当患者仍在接受药物治疗时，进行了 UVA-核黄素治疗。
UVA-核黄素 CXL 治疗后 1 周，基质浸润似乎不活跃。然而，第二周注意到复发，并在第一周后 3 周计划并进行了第二次 UVA-核黄素治疗。上皮缺损消失，从第二次 UVA-核黄素治疗的第一周开始，基质浸润一直不活跃，直到第 6 个月的最后一次随访检查。
对于药物治疗无效的角膜溃疡，可考虑使用 UVA-核黄素 CXL 进行治疗。
Zotero 插件