칸디다 알비칸스 각막염 환자에서 동결보존각막을 이용한 치료적 각막이식술 1예 = A Case of Therapeutic Keratoplasty Using Cryo-preservative Cornea in Candida albicans Keratitis

국문 초록 (Abstract)

목적: 칸디다 알비칸스 각막염 환자를 동결보존각막을 이용한 치료적 각막이식술을 시행하여 치료하였기에 이를 보고하고자 한다. 증례요약: 77세 여자 환자가 3일 전부터 시작된 좌안의 통증 및 시력저하를 주소로 내원하였다. 세극등현미경검사상 각막중심 상측부에 1.2 mm 직경의 기질침윤을 동반한 원형의 상피결손과 갈색 색소침착을 보였고 전방내 염증세포 및 모양체염막 소견을 보였다. 칸디다 각막염 의심하에 Optisol-GS？？ (Bausch & Lomb, Irvine, CA, USA)에 동결 보존된 공여각막을 이용하여 치료적 전층각막이식술을 시행하면서 전방내 균락과 감염된 홍채를 일부 절제하였다. 이후 유리체강내 또는 전방내에 암포테리신 B 또는 보리코나졸 주사술을 교대로 시행하였으며 전층각막이식술 후 2주경에 감염 양상은 소실되었다. 이후 외래 경과관찰에서 감염의 재발소견은 보이지 않았다. 결론: 동결 보존된 각막을 이용한 치료적 각막이식술은 칸디다 감염으로 인한 각막염에서 즉각적이며 효과적인 치료법으로 이용될 수 있다. 〈대한안과학회지 2016;57(7):1170-1175〉

다국어 초록 (Multilingual Abstract)

Purpose: To report a case treated with therapeutic keratoplasty using a cryo-preserved cornea in a patient with Candida albicans keratitis. Case summary: A 77-year-old female visited our clinic because of left ocular pain and visual disturbance for 3 days. Microscopic slit lamp examination revealed a 1.2 mm sized round corneal epithelial defect with deep stromal infiltration, brownish pigmentation and signs of inflammation with cyclitic membranes in the anterior chamber. On suspicion of Candida keratitis, we performed penetrating keratoplasty using a cryo-preserved donor cornea in Optisol-GS？？ (Bausch & Lomb, Irvine, CA, USA) solution with excision of the infected iris and colony of the anterior chamber. After the procedure, injection of intravitreal or intracameral amphotericin B and voriconazole were administered alternately. At 2 weeks after the second surgery, infection signs disappeared. At the follow-up in the outpatient clinic, signs of infection were not observed. Conclusions: Therapeutic keratoplasty using a cryo-preserved donor cornea can be an immediate and effective therapeutic strategy for Candida albicans keratitis. J Korean Ophthalmol Soc 2016;57(7):1170-1175

목차 (Table of Contents)

• 증례보고
• 고 찰
• REFERENCES

참고문헌 (Reference)

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