Power W J, Tugal-Tutkun I, Foster C S
Department of Cornea, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston 02114, USA.
Ophthalmology. 1998 Apr;105(4):637-42. doi: 10.1016/S0161-6420(98)94017-9.
This study aimed to review the presenting features, treatment administered to, histopathologic findings, and complications encountered in a cohort of patients with atopic keratoconjunctivitis.
The study design was a retrospective cohort series.
The medical records of 20 patients with atopic keratoconjunctivitis and a minimum follow-up of 3 years were reviewed.
Conjunctival and corneal complications, visual acuity before and after surgery, and histopathologic features on conjunctival biopsy were measured.
Significant keratopathy developed in 70% of patients, corneal neovascularization in 60%, fornix foreshortening in 25%, and symblepharon in 20% during the course of their disease. Eleven patients (12 eyes) required penetrating keratoplasty (3 for tectonic purposes and 8 for visual rehabilitation). Vision improved by four or more lines of Snellen acuity in four eyes, improved by two lines in two eyes, remained the same in five eyes, and worsened by two lines in one eye after keratoplasty. Cataract surgery was performed in seven patients (nine eyes) with vision improving by four or more lines in six patients (eight eyes).
Atopic keratoconjunctivitis is a potentially blinding disease that may result in a poor visual outcome as a result of corneal complications. Elective surgical intervention may be of benefit and can be considered in those patients whose inflammation is well controlled.
本研究旨在回顾一组特应性角结膜炎患者的临床表现、接受的治疗、组织病理学发现及并发症。
本研究设计为回顾性队列研究。
回顾了20例特应性角结膜炎患者的病历，这些患者至少随访3年。
测量结膜和角膜并发症、手术前后视力以及结膜活检的组织病理学特征。
70%的患者在病程中出现严重角膜病变，60%出现角膜新生血管，25%出现穹窿缩短，20%出现睑球粘连。11例患者（12只眼）需要进行穿透性角膜移植术（3例用于结构性目的，8例用于视力康复）。角膜移植术后，4只眼的视力提高了4行或更多行Snellen视力，2只眼提高了2行，5只眼视力不变，1只眼视力下降了2行。7例患者（9只眼）接受了白内障手术，6例患者（8只眼）的视力提高了4行或更多行。
特应性角结膜炎是一种潜在致盲性疾病，可能因角膜并发症导致视力预后不良。对于炎症得到良好控制的患者，选择性手术干预可能有益，可以考虑。
