Thermokeratoplasty and amniotic membrane transplantation for refractory corneal hydrops in a patient with pellucid marginal degeneration

Archivos de la Sociedad Espanola de Oftalmologia Pub Date : 2024-12-01 DOI:10.1016/j.oftale.2024.10.005

C. Klein-Burgos , L. Sanjuán-Riera , M. Larrañaga-Cores , E. Fernández-Gutiérrez , A. Boto-de los Bueis

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Abstract

A 57-year-old male presented at our clinic with acute corneal hydrops. He had been diagnosed with pellucid marginal degeneration (PMD) three years before.

Conservative treatment as well as intracameral air injections failed to resolve the corneal edema, so we decided to perform a thermokeratoplasty (TKP) associated with an amniotic membrane transplantation (AMT). Two weeks after the procedure the patient did not report having any pain, corneal edema resolved, and best spectacle corrected visual acuity (BSCVA) improved from counting fingers to 1 logMAR. During the two-year follow-up the patient has been asymptomatic, BSCVA is 0.2 logMAR, corneal steepness has reduced in inferior perifery from 71.3 diopters (D) to 56.7 D and just a mild leukoma is present at the original hydrops presentation site.

TKP combined with AMT should be considered as a treatment option in acute corneal hydrops, especially in those with peripheral location as PMD, uncompliant patients, and refractory cases.

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热角膜移植术和羊膜移植治疗一名透明边缘变性患者的难治性角膜水肿。

一名 57 岁的男性因急性角膜水肿来我院就诊。三年前，他被诊断为透明边缘变性（PMD）。保守治疗和巩膜内注射空气都未能缓解角膜水肿，因此我们决定为他实施热角膜移植术（TKP）和羊膜移植术（AMT）。术后两周，患者没有任何疼痛感，角膜水肿消退，最佳眼镜矫正视力（BSCVA）从数指提高到 1 logMAR。在两年的随访中，患者一直没有任何症状，最佳眼镜矫正视力为 0.2 logMAR，角膜下周边陡度从 71.3 屈光度 (D) 降至 56.7 D，在最初出现水肿的部位仅有一个轻微的白瘤。TKP 联合 AMT 应被视为急性角膜水肿的一种治疗方案，尤其适用于那些周边位置为 PMD 的患者、不服从治疗的患者和难治性病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Archivos de la Sociedad Espanola de Oftalmologia

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