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[各种病因的角膜炎后自发性角膜积血]

[Spontaneous hematocornea after keratitis of various etiology].

作者信息

Giessler S, Gross M, Struck H G

机构信息

Klinik und Poliklinik für Augenheilkunde, Martin Luther Universität Halle Wittenberg.

出版信息

Klin Monbl Augenheilkd. 1997 Jul;211(1):65-7. doi: 10.1055/s-2008-1035098.

Abstract

BACKGROUND

Corneal blood staining may occur as a serious complication of persisting hyphema. In our two cases the corneal blood staining is a result of direct bleeding in the corneal stroma.

HISTORY AND SIGNS

A female patient presented with a corneal blood staining through rupture of reopened vessels in interstitial keratitis of congenital syphilis after physical effort with high blood pressure. The second patient presented with a blood staining caused by a vessel errosion after corneal ulceration.

THERAPY AND OUTCOME

The clearing of the blood staining is thought to be a result of the phagocytic action of the keratocytes and from a diffusion of hemoglobin into the conjunctival circulation and the anterior chamber (2). The therapeutic efforts are directed toward prevention of corneal blood staining. At the first sign of microscopic blood staining of the cornea a surgical evacuation of hyphema is necessary. In our two cases there wasn't a hyphema, so it was only possible to treated the corneal ulcer, entropion and systemic hypertension.

CONCLUSION

The clinician has to wait for a spontaneous clearing, although it may take 2 or 3 years or more. In this case a penetrating keratoplasty is indicated.

摘要

背景

角膜血染可能作为持续性前房积血的一种严重并发症出现。在我们的两个病例中,角膜血染是角膜基质直接出血的结果。

病史与体征

一名女性患者在先天性梅毒间质性角膜炎中,因体力活动及高血压导致血管重新开放破裂,出现角膜血染。第二名患者因角膜溃疡后血管糜烂导致血染。

治疗与结果

角膜血染的清除被认为是角膜细胞吞噬作用以及血红蛋白扩散至结膜循环和前房的结果(2)。治疗措施旨在预防角膜血染。在角膜出现微小血染的首个迹象时,手术清除前房积血是必要的。在我们的两个病例中没有前房积血,所以仅能治疗角膜溃疡、睑内翻和全身性高血压。

结论

临床医生必须等待其自行清除,尽管这可能需要2年、3年或更长时间。在这种情况下,需行穿透性角膜移植术。

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