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治疗性穿透性角膜移植术治疗感染所致角膜穿孔1例

Therapeutic Penetrating Keratoplasty in a Case of Corneal Perforation Caused by Infection.

作者信息

Imai Kazuki, Sumioka Takayoshi, Iwanishi Hiroki, Takada Yukihisa, Murata Shin'ichi, Iwamoto Ryuta, Okada Yuka, Saika Shizuya

机构信息

Department of Ophthalmology, School of Medicine, Wakayama Medical University, Wakayama 641-0012, Japan.

Department of Clinical Pathology, School of Medicine, Wakayama Medical University, Wakayama 641-0012, Japan.

出版信息

Pathogens. 2022 Apr 29;11(5):526. doi: 10.3390/pathogens11050526.

Abstract

: Corneal infection of is uncommon and usually limited to the anterior stroma. However, we observed a case of corneal stromal perforation caused by this fungus under a compromised condition. : A 73-year-old woman consulted us with a severe corneal ulceration. She was a tangerine orange farmer who suffered from rheumatoid arthritis for more than ten years. Before consultation with us, she received pterygium excision in her right eye. She then developed a corneal ulceration and received topical glucocorticoid therapy upon diagnosis of rheumatoid arthritis-related stromal ulcer in the eye. At the first consultation with us, a corneal ulceration was observed in the inferotemporal area of her right cornea. Biological examination detected a filamentous fungus, . Topical and systemic antifungal treatments were not significantly effective. Fourteen days after consultation, the lesion grew worse, leading to stromal perforation, which was treated by therapeutic penetrating keratoplasty using a preserved corneal button. : Topical glucocorticoid could accelerate the growth of before diagnosis, even though the primary cause of corneal ulceration development might be rheumatoid arthritis.

摘要

角膜感染并不常见,通常局限于前基质层。然而,我们观察到在一种受损情况下,这种真菌导致了角膜基质穿孔的病例。:一名73岁女性因严重角膜溃疡前来就诊。她是一名柑橘种植户,患有类风湿关节炎十余年。在来我们这里就诊之前,她右眼接受了翼状胬肉切除术。之后她出现了角膜溃疡,在被诊断为眼部类风湿关节炎相关基质溃疡后接受了局部糖皮质激素治疗。在首次来我们这里就诊时,在她右眼角膜颞下区域观察到角膜溃疡。生物学检查检测到一种丝状真菌,。局部和全身抗真菌治疗效果不显著。就诊14天后,病情恶化,导致基质穿孔,通过使用保存的角膜片进行治疗性穿透性角膜移植术进行治疗。:尽管角膜溃疡发展的主要原因可能是类风湿关节炎,但在诊断前局部糖皮质激素可能会加速真菌的生长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c59/9145637/0a045f3ecc1f/pathogens-11-00526-g001.jpg

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