Özbek-Uzman Selma, Burcu Ayşe, Yalnız-Akkaya Züleyha, Şingar-Özdemir Evin, Örnek Firdevs
University of Health Sciences, Ankara Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey.
Turk J Ophthalmol. 2018 Jun;48(3):142-145. doi: 10.4274/tjo.23865. Epub 2018 Jun 28.
Infectious keratitis after corneal lamellar surgery is a rare complication. In this report, we present unexpected complications after crescentic lamellar wedge resection (CLWR) and their treatment in a patient with pellucid marginal degeneration. A 42-year-old male patient developed fungal keratitis due to in the late postoperative period after CLWR. Infection was controlled with medical treatment. However, recurrent intraocular infections and cataract formation occurred, probably due to capsular damage and inoculation of microorganisms into the crystalline lens during antifungal drug injection. Lensectomy was performed due to cataract progression and recurrence of the infection when treatment was discontinued. Amphotericin B was administered to the anterior chamber at the end of the operation. Four months later, an intraocular lens was implanted and corneal cross-linking treatment was performed. At the last visit, visual acuity reached 9/10. This case shows that good visual acuity can be achieved with appropriate treatment of fungal keratitis and all associated complications after CLWR.
角膜板层手术后的感染性角膜炎是一种罕见的并发症。在本报告中，我们介绍了一名透明边缘变性患者在新月形板层楔形切除术（CLWR）后出现的意外并发症及其治疗情况。一名42岁男性患者在CLWR术后晚期因[此处原文缺失原因]发生真菌性角膜炎。通过药物治疗控制了感染。然而，可能由于抗真菌药物注射期间晶状体囊膜损伤和微生物接种到晶状体中，发生了复发性眼内感染和白内障形成。由于白内障进展以及停止治疗后感染复发，进行了晶状体切除术。手术结束时向前房注射两性霉素B。四个月后，植入人工晶状体并进行了角膜交联治疗。在最后一次随访时，视力达到了9/10。该病例表明，对CLWR术后真菌性角膜炎及所有相关并发症进行适当治疗可获得良好视力。
