윤부포함 전체 각막이식 2예
Two Cases of Whole Corneo-Limbal Transplantation
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목적: 윤부포함 전체 각막이식으로 수술을 시행한 2예의 임상경과를 보고하고자 한다. 증례요약: 각막융해로 각각 3회의 동종각막이식술을 및 윤부이식술을 받았으나 각막괴사 재발로 인한 주변부 각막천공과 중심부각막거부반응이 발생한 환자와, 화학화상 후 2회의 동종각막이식술 및 윤부이식술을 시행하였으나, 이식실패로 각막괴사 및 각막천공이 발생한 환자 2명 2안을 대상으로 윤부포함 전체각막이식술을 시행하였다. 평균 19개월의 경과관찰 동안 두 환자에서 모두안압이 상승하여 모양체광응고술을 시행하였으며, 거부반응은 발생하였으나, 더이상의 괴사 및 천공은 발생되지 않았고, 안구유지가 가능하였다. 결론: 윤부 포함 전체 각막이식은 윤부결핍에 의한 각막 괴사진행의 천공은 막을 수 있었고, 윤부결핍으로 인한 이러한 각막괴사성질환에서 윤부이식 및 각막이식 실패 시 안구 유지목적의 대안으로 고려해 볼 수 있다.
Abstract
Purpose: To report the clinical outcomes of total corneolimbal transplantation in two cases. Case summary: One patient, who previously underwent three rounds of penetrating keratoplasty and limbal transplantation for uncontrollable peripheral and central corneal melting, received total corneolimbal transplantation. The other patient who underwent penetrating keratoplasty with limbal transplanation for a chemical burn and who did not experience corneal perforation also received total corneolimbal transplantation. During the average 19 months of follow-up, cyclophotocoagulation was performed to control high intraocular pressure in both patients. Both eyes were tectonically maintained without further corneal destruction despite poor visual acuity and rejection. Conclusions: Total corneolimbal transplantation may be an effective tectonic procedure for corneal melting. This procedure can be considered as another option for patients with corneal melting after failed limbal and corneal transplantation.
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