Newman D K, Isaacs J D, Watson P G, Meyer P A, Hale G, Waldmann H
Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, UK.
Eye (Lond). 1995;9 ( Pt 5):564-9. doi: 10.1038/eye.1995.140.
We report a patient with peripheral rheumatoid corneal melting who developed a corneal perforation in one eye requiring tectonic keratoplasty. Nine consecutive corneal grafts were rapidly destroyed despite systemic immunosuppression with corticosteroid, cyclophosphamide, azathioprine and cyclosporin A. A rejection episode was observed in one graft before it melted and allograft rejection may have contributed to the destruction of other grafts. Corneal graft survival was ultimately achieved by systemic immunosuppression with the anti-lymphocyte monoclonal antibody, CAMPATH-1H. A single episode of rejection developed in the early post-operative period which was easily reversed by topical corticosteroid. Corneal melting has not recurred and the graft has now remained intact and clear for 24 months. Anti-lymphocyte monoclonal antibodies may therefore provide effective immunosuppression in the treatment of refractory ocular disorders.
我们报告了一例患有外周类风湿性角膜溶解的患者，其一只眼睛发生角膜穿孔，需要进行结构性角膜移植术。尽管使用皮质类固醇、环磷酰胺、硫唑嘌呤和环孢素A进行全身免疫抑制，但连续9次角膜移植均迅速被破坏。在一次移植融化前观察到排斥反应，同种异体移植排斥可能导致了其他移植的破坏。最终通过使用抗淋巴细胞单克隆抗体CAMPATH-1H进行全身免疫抑制实现了角膜移植存活。术后早期出现了一次排斥反应，通过局部使用皮质类固醇很容易逆转。角膜溶解未再复发，移植片现已保持完整且透明24个月。因此，抗淋巴细胞单克隆抗体在治疗难治性眼部疾病中可能提供有效的免疫抑制作用。
