Ono Takashi, Iwasaki Takuya, Takada Keita, Tokuda Shota, Sakisaka Toshihiro, Mori Yosai, Nejima Ryohei, Kakibuchi Masao, Miyai Takashi, Miyata Kazunori
Miyata Eye Hospital, 6-3, Kuraharacho, Miyakonojo, 885-0051, Miyazaki, Japan.
Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Jpn J Ophthalmol. 2025 Jan;69(1):152-158. doi: 10.1007/s10384-024-01156-1. Epub 2025 Jan 3.
This study aimed to report the incidence, characteristics, and prognosis of corneal perforation in patients with leprosy.
Retrospective observational study.
Patients who presented with leprosy and visited a specialised ophthalmology hospital (Miyata Eye Hospital, Miyazaki, Japan) between 1980 and 2020 were included. Their medical charts were retrospectively reviewed, and the incidence of lagophthalmos and corneal perforation was examined. Additionally, the presentation, treatment, and prognosis of patients with corneal perforations were assessed.
In total, the records of 472 eyes of 236 patients (128 men and 108 women; mean age, 81.2 ± 7.5 years) diagnosed with leprosy were reviewed. Forty-one patients were diagnosed with lagophthalmos, and two of these patients (4.8%) showed signs of corneal perforation. Patients with lagophthalmos presented significantly more frequently with cicatricial contraction of eyelids (p < 0.001), superficial punctate keratopathy (p < 0.001), epithelial defect (p = 0.039), and corneal ulcer (p < 0.001) compared with patients without lagophthalmos. Patients with corneal perforation had uveitis more frequently compared with those without corneal perforation (p = 0.01).
Patients with leprosy frequently develop lagophthalmos. Patients with uveitis associated with leprosy are especially at risk of corneal perforation.
本研究旨在报告麻风病患者角膜穿孔的发生率、特征和预后。
回顾性观察研究。
纳入1980年至2020年间就诊于一家专业眼科医院（日本宫崎县宫田眼科医院）的麻风病患者。对他们的病历进行回顾性审查，检查兔眼和角膜穿孔的发生率。此外，对角膜穿孔患者的临床表现、治疗和预后进行评估。
总共审查了236例（128例男性和108例女性；平均年龄81.2±7.5岁）被诊断为麻风病患者的472只眼睛的记录。41例患者被诊断为兔眼，其中2例（4.8%）出现角膜穿孔迹象。与无兔眼的患者相比，兔眼患者眼睑瘢痕性收缩（p<0.001）、浅层点状角膜炎（p<0.001）、上皮缺损（p=0.039）和角膜溃疡（p<0.001）的发生率明显更高。与无角膜穿孔的患者相比，角膜穿孔患者葡萄膜炎的发生率更高（p=0.01）。
麻风病患者经常出现兔眼。患有与麻风病相关葡萄膜炎的患者尤其有角膜穿孔的风险。
