Descemet stripping endothelial keratoplasty after cytomegalovirus corneal endotheliitis and immunosuppression for Mooren's ulcer.
Corneal transplantation
Corneal ulcer
Cytomegalovirus infections
Immunosuppressive agents
Keratitis
Visual acuity
Journal
American journal of ophthalmology case reports
ISSN: 2451-9936
Titre abrégé: Am J Ophthalmol Case Rep
Pays: United States
ID NLM: 101679941
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
12
05
2020
revised:
21
10
2020
accepted:
04
04
2021
entrez:
3
5
2021
pubmed:
4
5
2021
medline:
4
5
2021
Statut:
epublish
Résumé
The aim of this report was to describe a case of cataract surgery and Descemet stripping automated endothelial keratoplasty (DSAEK) after cytomegalovirus (CMV) corneal endotheliitis and bullous keratopathy (BK) following immunosuppressive treatment for Mooren's ulcer. A 64-year-old man was referred to our hospital because of peripheral ulcerative keratitis in his left eye. He had a history of trabeculectomy for open angle glaucoma in his left eye. He was diagnosed with Mooren's ulcer and treated with topical betamethasone and tacrolimus with systemic cyclosporine. The corneal ulcer improved, but the peripheral cornea thinned from 6 to 12 and 0-2 o'clock. Five months later, cells were observed in the left anterior chamber, and real-time polymerase chain reaction examination of the aqueous humor showed CMV-DNA-positive results. The patient was diagnosed with CMV corneal endotheliitis, and oral ganciclovir was administered. Fifteen months after the initial presentation, BK appeared with decreased vision to 20 cm/n. d. After confirmation of negative CMV-DNA in the aqueous humor, DSAEK was performed following cataract surgery. The postoperative visual acuity recovered to 0.3. Mooren's ulcer exacerbation and CMV corneal endotheliitis did not recur postoperatively. This is the first report of a case in which a patient with Mooren's ulcer developed BK due to CMV corneal endotheliitis and required DSAEK. Cataract surgery and DSAEK could be performed without issue by creating the main wound and side ports in a manner that avoids the thinned parts of the cornea.
Identifiants
pubmed: 33937582
doi: 10.1016/j.ajoc.2021.101088
pii: S2451-9936(21)00097-9
pmc: PMC8079431
doi:
Types de publication
Case Reports
Langues
eng
Pagination
101088Informations de copyright
© 2021 Published by Elsevier Inc.
Déclaration de conflit d'intérêts
The authors have no financial disclosures.
Références
Arch Ophthalmol. 1991 Jul;109(7):988-92
pubmed: 2064583
Am J Ophthalmol. 2008 May;145(5):834-40
pubmed: 18255045
Br J Ophthalmol. 2015 Jan;99(1):54-8
pubmed: 25075122
J Cataract Refract Surg. 2005 Feb;31(2):359-62
pubmed: 15767159
J Cataract Refract Surg. 1999 Jan;25(1):7-9
pubmed: 9888070
Cornea. 2017 Jan;36(1):108-112
pubmed: 27661068
Br J Ophthalmol. 2018 Sep;102(9):1293-1297
pubmed: 29363530
Ophthalmology. 1980 Feb;87(2):140-50
pubmed: 6992019
Arch Ophthalmol. 1998 Apr;116(4):535-7
pubmed: 9565058
Cornea. 2019 Jan;38(1):120-122
pubmed: 30379718
Am J Ophthalmol. 1976 Dec;82(6):835-40
pubmed: 793402
Cornea. 2019 Apr;38(4):413-418
pubmed: 30614903
J Cataract Refract Surg. 2007 Dec;33(12):2018-22
pubmed: 18053897
Cornea. 1993 Nov;12(6):481-8
pubmed: 8261778
Am J Ophthalmol. 1987 Jan 15;103(1):53-6
pubmed: 3541631
Invest Ophthalmol Vis Sci. 1995 Jul;36(8):1541-7
pubmed: 7601634
Ocul Immunol Inflamm. 2015;23(5):378-83
pubmed: 25207970
J Cataract Refract Surg. 2006 Mar;32(3):411-8
pubmed: 16631048
J Cataract Refract Surg. 2017 Aug;43(8):1044-1049
pubmed: 28917404
Cornea. 2007 May;26(4):493-7
pubmed: 17457204
J Cataract Refract Surg. 2007 Mar;33(3):376-9
pubmed: 17321384
Ophthalmology. 2007 Apr;114(4):798-803
pubmed: 17207531
Ocul Immunol Inflamm. 2018;26(1):90-93
pubmed: 28448732