后弹力层内皮角膜移植术后迟发性界面性角膜炎。
Delayed postoperative interface keratitis due to after Descemet membrane endothelial keratoplasty.
机构信息
Cornea and Anterior Segment, LV Prasad Eye Institute, Hyderabad, India.
Cornea and Anterior Segment, LV Prasad Eye Institute, Hyderabad, India
出版信息
BMJ Case Rep. 2021 Jan 27;14(1):e238389. doi: 10.1136/bcr-2020-238389.
To report the clinical course and management of interface keratitis due to after Descemet membrane endothelial keratoplasty (DMEK). A 64-year-old man underwent DMEK, with unevenful immediate postoperative course, with a visual recovery of 20/30 at 2 weeks. At 3 months of clinical visit, interface keratitis was noted. DMEK graft removal with stromal bed scrapings was performed. A diagnosis of interface keratitis was made. The patient responded favourably to antibiotic susceptibility-guided intensive treatment with vancomycin 5% with complete resolution of infection. After 2 months of graft removal, Descemet stripping endothelial keratoplasty (DSEK) was performed. The corneal clarity was restored and the best corrected visual acuity was 20/40 at last follow-up of 1 year. should be kept as a differential in delayed onset interface keratitis after DMEK. After microbiological cure with antibiotic therapy, visual rehabilitation with DSEK restores corneal clarity and results in favourable visual outcome.
报告一例因 Descemet 膜内皮角膜移植（DMEK）术后发生界面性角膜炎的临床经过和处理。一名 64 岁男性患者接受了 DMEK，术后即刻视力恢复不佳，术后 2 周时视力恢复至 20/30。3 个月临床就诊时发现界面性角膜炎。行 DMEK 移植物去除联合基质床刮除术。诊断为界面性角膜炎。患者对万古霉素 5%药敏引导的强化治疗反应良好，感染完全消退。移植物去除后 2 个月行 Descemet 撕囊内皮角膜移植（DSEK）。最终随访 1 年时，角膜透明度恢复，最佳矫正视力为 20/40。在 DMEK 后迟发性界面性角膜炎中应考虑该病原体。经抗生素治疗微生物治愈后，行 DSEK 视力康复可恢复角膜透明度，并获得良好的视力结果。
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