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[酒渣鼻角膜炎合并角膜穿孔的蘑菇状角膜移植术(临床病例)]

[Mushroom keratoplasty in rosacea keratitis complicated by corneal perforation (a clinical case)].

作者信息

Trufanov S V, Krakhmaleva D A, Zaitsev A V, Salovarova E P, Tekeeva L Yu, Budnikova E A

机构信息

Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021.

出版信息

Vestn Oftalmol. 2019;135(5. Vyp. 2):215-219. doi: 10.17116/oftalma2019135052215.

Abstract

Rosacea is a polyethiologic chronic inflammatory disease with varying clinical manifestations. It is primarily a dermatologic disease, which often manifests in the eyes affecting eyelids, cornea and conjunctiva. The leading role in the pathological process belongs to disruption of regulatory mechanisms in the vascular, immune and nervous systems. It is accompanied by increased levels of metalloproteinases and vascular endothelial growth factor (VEGF). Treatment depends on the severity of the disease and may vary from hygiene of the eyelid margins and use of artificial tears for dry eye disease management, to antibiotics and anti-inflammatory agents in moderate cases, and surgical treatment in severe or neglected state. A clinical case of severe rosacea shows that keratoplasty with mushroom-shaped profile of the surgical incision helps achieve good functional results and reduce the post-operative rehabilitation time, while significantly reducing the risk of postsurgical complications. Anti-VEGF therapy significantly reduces the risk of histoincompatibility reaction typical for rosacea keratitis.

摘要

酒渣鼻是一种具有多种临床表现的多病因慢性炎症性疾病。它主要是一种皮肤病,常累及眼部,影响眼睑、角膜和结膜。病理过程中的主要作用在于血管、免疫和神经系统调节机制的破坏。它伴有金属蛋白酶和血管内皮生长因子(VEGF)水平升高。治疗取决于疾病的严重程度,可能从眼睑边缘卫生护理和使用人工泪液治疗干眼症,到中度病例使用抗生素和抗炎药,以及在严重或被忽视的情况下进行手术治疗。一例严重酒渣鼻的临床病例表明,采用蘑菇形手术切口轮廓的角膜移植术有助于取得良好的功能效果并缩短术后康复时间,同时显著降低术后并发症的风险。抗VEGF治疗可显著降低酒渣鼻角膜炎典型的组织不相容反应风险。

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