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用于角膜炎-角膜胶原交联和穿透性角膜移植术的同步非中心光活化发色团治疗重度边缘性 spp. 角膜炎：一种新手术技术的描述

Simultaneous Noncentered Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking and Penetrating Keratoplasty for Treatment of Severe Marginal spp. Keratitis: A Description of a New Surgical Technique.

作者信息

Balparda Kepa, Mejia-Turizo Juan Carlos, Herrera-Chalarca Tatiana

机构信息

Department of Cornea and Refractive Surgery, Clínica de Oftalmología Sandiego, Medellín, Colombia.

Department of Ophthalmology, Clínica de Oftalmología Sandiego, Medellín, Colombia.

出版信息

Case Rep Ophthalmol Med. 2017;2017:6987896. doi: 10.1155/2017/6987896. Epub 2017 Dec 14.

DOI:10.1155/2017/6987896
PMID:29387501
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5745696/
Abstract

The purpose of this article is to describe the use of simultaneous noncentered photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL) combined with penetrating keratoplasty in the treatment of a severe marginal spp. keratitis case with imminent corneal perforation. It is a retrospective case report study; it was performed by collecting clinical data, images, video, and postoperative evaluations. The clinical control of the infection was accomplished, despite difficulties in obtaining antifungal medications due to the patient's extremely poor socioeconomic status and essentially nonexistent health insurance. We can conclude that combining simultaneous decentered PACK-CXL with centered penetrating keratoplasty appears to be a safe and effective way of treating patients with fungal marginal keratitis with corneal perforation, in which regular penetrating keratoplasty alone would leave fungal elements in the receptor corneal tissue, which would predispose to infection of the graft.

摘要

本文的目的是描述在治疗一例伴有即将发生角膜穿孔的严重边缘性真菌性角膜炎病例时，同步非中心光活化发色团用于角膜炎-角膜胶原交联术（PACK-CXL）联合穿透性角膜移植术的应用情况。这是一项回顾性病例报告研究；通过收集临床数据、图像、视频及术后评估来进行。尽管由于患者社会经济状况极差且基本没有医疗保险，获取抗真菌药物存在困难，但感染的临床控制仍得以实现。我们可以得出结论，将同步偏心PACK-CXL与中心穿透性角膜移植术相结合，似乎是治疗伴有角膜穿孔的真菌性边缘性角膜炎患者的一种安全有效的方法，而单纯常规穿透性角膜移植术会在受体角膜组织中残留真菌成分，这会使移植物易于感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/fe519d2887aa/CRIOPM2017-6987896.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/4b04bce0e674/CRIOPM2017-6987896.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/dc3dd64cbe02/CRIOPM2017-6987896.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/8cd82fc13858/CRIOPM2017-6987896.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/3092785ca781/CRIOPM2017-6987896.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/dbf159cfb93a/CRIOPM2017-6987896.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/fe519d2887aa/CRIOPM2017-6987896.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/4b04bce0e674/CRIOPM2017-6987896.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/dc3dd64cbe02/CRIOPM2017-6987896.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/8cd82fc13858/CRIOPM2017-6987896.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/3092785ca781/CRIOPM2017-6987896.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/dbf159cfb93a/CRIOPM2017-6987896.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba30/5745696/fe519d2887aa/CRIOPM2017-6987896.006.jpg

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本文引用的文献

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Corneal Collagen Cross-Linking for Infectious Keratitis: A Systematic Review and Meta-Analysis.用于感染性角膜炎的角膜胶原交联：系统评价与荟萃分析。
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Intraoperative Photoactivated Chromophore for Infectious Keratitis-Corneal Cross-Linking (PACK-CXL) During Penetrating Keratoplasty for the Management of Fungal Keratitis in an Immunocompromised Patient.免疫功能低下患者穿透性角膜移植术中用于治疗真菌性角膜炎的术中光活化发色团-角膜交联术（PACK-CXL）
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