Anterior Stromal Melt With Corneal Allogeneic Intrastromal Ring Segments in a Patient With Severe Atopy.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-03-17 DOI:10.1097/ICO.0000000000003851

Shady T Awwad, Karen E Asfar, Jeremiah Gendy, Soosan Jacob, Jad F Assaf

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Abstract

Purpose: To report the first case of anterior stromal melt after insertion of a corneal allogeneic intrastromal ring segment (CAIRS) in a patient with severe atopy.

Methods: A 27-year-old woman with keratoconus, severe atopy, and giant upper tarsal conjunctival papillae underwent uneventful insertion of a CAIRS in her right eye. 4 months later, she presented with severe exacerbation of her atopy, necessitating anti-IgE monoclonal antibody therapy initiation.

Results: Slit-lamp examination revealed thinning of the corneal stroma overlying the CAIRS over a 30-degree sector, also documented by optical coherence tomography. There was a resolution of the giant conjunctival papillae. The patient was started on topical cyclosporine and a tapering loteprednol regimen, along with the anti-IgE treatment. The last follow-up showed stability in visual acuity, stromal thickness, and topographic parameters, which remained better than preoperatively.

Conclusions: Anterior stromal melt, commonly seen with synthetic segments, can rarely develop after CAIRS implantation, in specific circumstances, such as severe inflammation and atopy. Prompt systemic and topical management can potentially stop progression and retain the implanted segment.

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严重特应性角膜异体间质环段前基质融化1例。

目的：报告一例严重特应性角膜异体间质环段植入术后角膜前基质融化的病例。方法：一名患有圆锥角膜，严重特应性畸形和睑上结膜乳头巨大的27岁女性，在她的右眼进行了无伤大耶的置入。4个月后，她出现严重的特应性加重，需要开始抗ige单克隆抗体治疗。结果：裂隙灯检查显示覆盖cair的角膜基质在30度范围内变薄，光学相干断层扫描也记录了这一点。巨大的结膜乳头溶解。患者开始使用局部环孢素和逐渐减少的洛替普诺方案，以及抗ige治疗。最后一次随访视力、间质厚度、地形参数稳定，优于术前。结论：在特殊情况下，如严重的炎症和特应性，CAIRS植入后很少发生前基质融化，常见于合成节段。及时的系统和局部处理可以潜在地阻止进展并保留植入的节段。

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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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.