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晚期眼内炎行DMEK移植物取出及玻璃体切除术后的视力恢复与内皮细胞再植:一例报告

Visual Recovery and Endothelial Repopulation after DMEK Graft Removal and Vitrectomy for Late Endophthalmitis: A Case Report.

作者信息

Szalai Eszter, Belin Michael W, Szijártó Zsuzsanna, Csutak Adrienne

机构信息

Department of Ophthalmology, University of Pecs Medical School, Pécs, Hungary.

Department of Ophthalmology and Vision Science, University of Arizona, Tucson, AZ, USA.

出版信息

Case Rep Ophthalmol. 2024 Oct 24;15(1):736-741. doi: 10.1159/000541644. eCollection 2024 Jan-Dec.

DOI:10.1159/000541644
PMID:39449735
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11501103/
Abstract

INTRODUCTION

The aim of the study was to report a unique case with excellent clinical outcomes after late endophthalmitis following Descemet's membrane endothelial keratoplasty (DMEK) surgery requiring donor graft removal without replacement.

CASE PRESENTATION

A 67-year-old female with a prior ocular history of bilateral cataract surgery, Fuchs endothelial dystrophy, and pseudophakic DMEK in the left eye presented with endophthalmitis 2 months after keratoplasty. DMEK graft removal without replacement with an intracameral washout, pars plana vitrectomy, intracameral, and intravitreal antibiotics resulted in an excellent visual outcome (20/25).

CONCLUSION

This is a unique case of late endophthalmitis following DMEK surgery requiring graft removal and pars plana vitrectomy with excellent visual recovery without donor replacement.

摘要

引言

本研究的目的是报告一例独特病例,该病例为在Descemet膜内皮角膜移植术(DMEK)手术后发生迟发性眼内炎,在无需更换供体移植物的情况下移除供体移植物后获得了优异的临床结果。

病例介绍

一名67岁女性,既往有双眼白内障手术、Fuchs内皮营养不良病史,左眼行假晶状体DMEK手术,角膜移植术后2个月出现眼内炎。在未更换移植物的情况下移除DMEK移植物,并进行前房冲洗、玻璃体切除术、前房和玻璃体内注射抗生素,最终获得了优异的视力结果(20/25)。

结论

这是一例DMEK手术后迟发性眼内炎的独特病例,该病例需要移除移植物并进行玻璃体切除术,且在未更换供体的情况下实现了优异的视力恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d222/11501103/6fb2b4066807/cop-2024-0015-0001-541644_F02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d222/11501103/4983a535e4a2/cop-2024-0015-0001-541644_F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d222/11501103/6fb2b4066807/cop-2024-0015-0001-541644_F02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d222/11501103/4983a535e4a2/cop-2024-0015-0001-541644_F01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d222/11501103/6fb2b4066807/cop-2024-0015-0001-541644_F02.jpg

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Cornea. 2023 Aug 1;42(8):980-985. doi: 10.1097/ICO.0000000000003131. Epub 2022 Sep 16.
2
Ocular Features and Clinical Approach to Cataract and Corneal Refractive Surgery in Patients with Myotonic Dystrophy.强直性肌营养不良患者白内障及角膜屈光手术的眼部特征与临床处理方法
Clin Ophthalmol. 2022 Aug 25;16:2837-2842. doi: 10.2147/OPTH.S372633. eCollection 2022.
3
Propionibacterium acnes endophthalmitis following transplantation of contaminated Descemet's membrane endothelial keratoplasty graft.
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Am J Ophthalmol Case Rep. 2021 Oct 27;24:101227. doi: 10.1016/j.ajoc.2021.101227. eCollection 2021 Dec.
4
A Close Look at the Clinical Efficacy of Rho-Associated Protein Kinase Inhibitor Eye Drops for Fuchs Endothelial Corneal Dystrophy.深入观察 Rho 相关蛋白激酶抑制剂滴眼剂治疗 Fuchs 内皮角膜营养不良的临床疗效。
Cornea. 2021 Oct 1;40(10):1225-1228. doi: 10.1097/ICO.0000000000002642.
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Corneal clearance and central endothelial cell repopulation despite graft detachment after Descemet membrane endothelial keratoplasty.尽管在Descemet膜内皮角膜移植术后移植物发生脱离,但角膜清除率和中央内皮细胞仍可重新增殖。
GMS Ophthalmol Cases. 2019 Apr 4;9:Doc14. doi: 10.3205/oc000103. eCollection 2019.
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