반복적인 전층각막이식실패 환자에서 데스메막박리 자동 각막내피층판이식술을 시행한 1예 = Descemet Stripping Automated Endothelial Keratoplasty for Repeated Penetrating Keratoplasty Graft Failure

국문 초록 (Abstract)

목적: 두 차례의 전층각막이식 후 재차 이식 실패가 발생하여 데스메막박리 자동 각막내피층판이식술을 시행한 사례를 보고하고자 한다. 증례요약: 33세 인도 국적의 남자 환자로 우안 아메바각막염이 발생하여 인도에서 2차례 전층각막이식수술 및 각막윤부이식을 시행받은 후 본원에 내원하였다. 경과 관찰 도중 우안 이차성 녹내장 진단하에 아메드밸브이식술을 시행하였으며, 우안 각막신생혈관에 진행하여 우안 결막후전술 및 양막이식술을 시행하였다. 이후 각막이식 실패 상태로 진행하여 데스메막박리 각막내피층판이식술을 시행하였다. 수술 후 7개월째 우안 나안시력 20/320으로 특별한 합병증 없이 유지되고 있다. 결론: 전층각막이식 후 각막신생혈관 및 녹내장수술로 인한, 각막내피세포 부전으로 반복적인 이식 실패가 발생한 환자에 있어서 기질 상태가 양호할 경우 데스메막박리 자동 각막내피층판이식술을 시행하여 합병증 없이 좋은 시력회복을 보였기에 문헌고찰과 함께 보고하는 바이다. 추후 국내에서 더 많은 수술 환자를 대상으로 한 연구가 필요하다.

다국어 초록 (Multilingual Abstract)

Purpose: To report a case of Descemet stripping automated endothelial keratoplasty (DSAEK) for graft failure after re-penetrating keratoplasty (PK). Case summary: A 33-year-old man of Indian nationality who had developed right eye amoeba keratitis and had received two penetrating keratoplasties and allogeneic kerato-limbal transplant in India sought treatment at our hospital. During the follow-up, Ahmed valve transplantation was performed under the diagnosis of secondary glaucoma in his right eye; the patient also underwent conjunctival recession and conjunctival permanent amniotic membrane transplantation as corneal neovascularization had progressed. Subsequently, the corneal transplantation failed and DSAEK was performed. At 7 months after the operation, the right-eye visual acuity was 20/320 without any complications. Conclusions: DSAEK may restore good vision without complications in patients with repeated corneal graft failure after PK from corneal endothelial cell failure followed by corneal neovascularization and glaucoma surgery but with good stromal conditions. We present this case, along with a review of the literature. Future studies will require more surgical patients.

목차 (Table of Contents)

• 증례보고 고찰

참고문헌 (Reference)

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