플릭텐각막염 환자에서 발생한 각막 천공

• 영문명: Corneal Perforation in Phlyctenular Keratitis
• 발행기관: 대한안과학회
• 저자명: 안용선 이진아 조양경,Yong Sun Ahn, MD, Jin A Lee, MD, Yang Kyung Cho, MD, PhD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume55,number2, 298~303쪽, 전체 6쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2014.02.15

영문 초록

Purpose: Corneal perforation from phlyctenular keratoconjunctivitis is rarely reported worldwide and no case has been reported in Korea. We report a case of corneal perforation in a patient with phlyctenular keratoconjunctivitis along with a literature review. Case summary: A 15-year-old female presented to our clinic with repetitive tears, conjunctival injection, and discomfort in her right eye for several months. Slit-lamp examination revealed oily plugs at the meibomian gland orifices with collarettes, conjunctival injection and a round, whitish elevated lesion accompanying neovascularization of the inferotemporal side of the cornea. As an initial treatment, topical antibiotic was given but no signs of improvement were observed. Hence, topical steroid was applied on suspicion of phlyctenular keratitis and the patient’s symptoms and corneal lesion improved. Two months later, the patient’s symptoms relapsed and the lesion was found progressing towards the central cornea. The treatment was restarted and the symptoms improved but the corneal lesion continuously progressed towards the center, thinning the central cornea. Seventeen months from the time of initial diagnosis, the patient revisited prior to the scheduled appointment complaining of abrupt tears in her right eye. Slit-lamp examination revealed a corneal perforation at the center of the thinned cornea. Hence, we performed an emergent tectonic corneal patch graft. After the operation, opacity remained covering the visual axis at the central cornea, thus penetrating keratoplasty was performed 10 months later. Henceforth, the patient has remained free of symptoms and visual acuity has been recovered. Conclusions: Usually phlyctenular keratoconjunctivitis responds well to treatment and does not have a significant influence on vision. However, occasionally phlyctenular keratoconjunctivitis may not respond to treatment and may spread to the central cornea causing loss of visual acuity and even corneal perforation in rare occasions. Therefore, in order to prevent such complications, prompt diagnosis and treatment are essential. J Korean Ophthalmol Soc 2014;55(2):298-303

키워드

Blepharitis, Corneal perforation, Penetrating keratoplasty, Phlyctenular keratoconjunctivitis, Tectonic corneal patch graft