Successful Treatment of Infectious Scleritis by Pseudomonas aeruginosa with Autologous Perichondrium Graft of Conchal Cartilage
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Infectious scleritis by Pseudomonas aeruginosa is a well-known vision-threatening disease. In particular, scleral trauma followingpterygium surgery may increase the risk of sclera inflammation. Surgical debridement and repair is necessary in patients who donot respond to medical treatments, such as topical and intravenous antibiotics. We reports herein the effectiveness of an autologousperichondrium conchal cartilage graft for infectious scleritis caused by Pseudomonas aeruginosa. This procedure was performedon four eyes of four patients with infectious scleritis who had previously undergone pterygium surgery at GyeongsangNational University Hospital (GNUH), Jinju, Korea from December 2011 to May 2012. Pseudomonas aeruginosa was identified incultures of necrotic scleral lesion before surgery. The conchal cartilage perichondrium graft was transplanted, and a conjunctivalflap was created on the scleral lesion. The autologous perichondrium conchal cartilage graft was successful and visual outcomewas stable in all patients, with no reports of graft failure or infection recurrence. In conclusion, autologous perichondrium conchalcartilage graft may be effective in surgical management of Pseudomonal infectious scleritis when non-surgical medical treatmentis ineffective. Further studies in larger, diverse populations are warranted to establish the effectiveness of the procedure.
Abstract
Infectious scleritis by Pseudomonas aeruginosa is a well-known vision-threatening disease. In particular, scleral trauma followingpterygium surgery may increase the risk of sclera inflammation. Surgical debridement and repair is necessary in patients who donot respond to medical treatments, such as topical and intravenous antibiotics. We reports herein the effectiveness of an autologousperichondrium conchal cartilage graft for infectious scleritis caused by Pseudomonas aeruginosa. This procedure was performedon four eyes of four patients with infectious scleritis who had previously undergone pterygium surgery at GyeongsangNational University Hospital (GNUH), Jinju, Korea from December 2011 to May 2012. Pseudomonas aeruginosa was identified incultures of necrotic scleral lesion before surgery. The conchal cartilage perichondrium graft was transplanted, and a conjunctivalflap was created on the scleral lesion. The autologous perichondrium conchal cartilage graft was successful and visual outcomewas stable in all patients, with no reports of graft failure or infection recurrence. In conclusion, autologous perichondrium conchalcartilage graft may be effective in surgical management of Pseudomonal infectious scleritis when non-surgical medical treatmentis ineffective. Further studies in larger, diverse populations are warranted to establish the effectiveness of the procedure.
참고문헌 (11)
- Yingbin Shang, "The Clinical Feature of Behçet’s Disease in Northeastern China", Yonsei Medical Journal, 50(5), pp.630~636 (2009), 연세대학교의과대학
- Jain V, "Microbial scleritis-experience from a developing country", Eye (Lond), 23, pp.255~261 (2009)
- Ho YF, "Infectious scleritis in Taiwan-a 10-year review in a tertiary-care hospital", Cornea, 33, pp.838~843 (2014)
- Hodson KL, "Epidemiology and visual outcomes in patients with infectious scleritis", Cornea, 32, pp.466~472 (2013)
- Lin CP, "Clinical experiences of infectious scleral ulceration: a complication of pterygium operation", Br J Ophthalmol, 81, pp.980~983 (1997)
- Parodi PC, "Lower lid reconstruction utilizing auricular conchal chondralperichondral tissue in patients with neoplastic lesions", Biomed Res Int, 2013, pp.837536~ (2013)
- Watson P, "The impact of new methods of investigation and treatment on the understanding of the pathology of scleral inflammation", Eye (Lond), 28, pp.915~930 (2014)
- Watson P, "The sclera and systemic disorders" (2012), JP Medical Ltd.
- Paula JS, "Atypical pneumococcal scleritis after pterygium excision: case report and literature review", Cornea, 25, pp.115~117 (2006)
- Nguyen QD, "Scleral patch graft in the management of necrotizing scleritis", Int Ophthalmol Clin, 39, pp.109~131 (1999)
- Togo T, "Identification of cartilage progenitor cells in the adult ear perichondrium:utilization for cartilage reconstruction", Lab Invest, 86, pp.445~457 (2006)