From the Department of Ophthalmology, Saarland University Medical Center, Homburg, Germany.
From the Department of Ophthalmology, Saarland University Medical Center, Homburg, Germany.
J Cataract Refract Surg. 2018 Jan;44(1):106-108. doi: 10.1016/j.jcrs.2017.10.046.
We report a case of corneal decompensation caused by recurrent herpetic endotheliitis that was treated successfully with Descemet membrane endothelial keratoplasty (DMEK). A 62-year-old woman presented with a history of recurrent herpetic infections in the right cornea. After topical and systemic treatment with antivirals and steroids for 5 months, DMEK combined with cataract surgery was performed. Two weeks after DMEK, the corrected distance visual acuity (CDVA) in the affected eye was 0.3 (20/60). One year postoperatively, the CDVA was 1.0 (20/20) and the slitlamp biomicroscopy showed no signs of graft rejection or herpetic recurrence. Corneal decompensation caused by herpetic endotheliitis used to be treated exclusively with penetrating keratoplasty. Descemet membrane endothelial keratoplasty combined with cataract surgery seems to be a favorable surgical option in the treatment of corneal endothelial decompensation after recurrent herpetic endotheliitis.
我们报告了一例因复发性疱疹性内皮炎引起的角膜失代偿，该病例通过 Descemet 膜内皮角膜移植（DMEK）成功治疗。一名 62 岁女性因右眼反复发作性疱疹感染就诊。经过抗病毒和类固醇药物局部和全身治疗 5 个月后，进行了 DMEK 联合白内障手术。DMEK 后 2 周，患眼的矫正视力（CDVA）为 0.3（20/60）。术后 1 年，CDVA 为 1.0（20/20），裂隙灯生物显微镜检查未见移植物排斥或疱疹复发迹象。过去，疱疹性内皮炎引起的角膜失代偿症仅通过穿透性角膜移植治疗。对于复发性疱疹性内皮炎后角膜内皮失代偿的治疗，Descemet 膜内皮角膜移植联合白内障手术似乎是一种有利的手术选择。
