유두절제술과 양막이식을 이용한 난치성 봄철각결막염의 치료 1예
A Case of Intractable Vernal Keratoconjunctivitis Treated by Papillectomy and Amniotic Membrane Transplantation
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목적: 약물치료에 반응하지 않는 난치성 봄철각결막염 환자에서 거대유두절제술과 상안검판 양막이식술을 동시에 시행하여 성공적으로 치료한 1예를 보고하고자 한다. 증례요약: 20세 여자 환자가 14세부터 호전과 악화를 반복하는 양안의 봄철각결막염으로 내원하였다. 점안 치료를 시행하였으나 호전되지 않았고 상안검판에 다수의 거대유두와 윤부종창이 생성되며 작열감, 소양증, 이물감 등의 증상이 진행되었다. 좌안 상안검판거대유두를 수술적으로 제거 후 양막을 절제부위에 이식하였고, 한 달 뒤 같은 방법으로 우안 거대유두 절제술을 시행하였다. 환자의 증상은 호전되었으며 6개월이 지난 현재 환자는 재발이나 별다른 합병증 없이 경과 관찰 중이다. 결론: 난치성 봄철각결막염에서 거대유두절제술과 양막이식술을 동시에 시행하는 것은 수술 후 재발률을 낮추고 증상을 호전시키는 데 효과적인 치료방법으로 생각된다.
Abstract
Purpose: To report a successful case of intractable vernal keratoconjunctivitis treated by papillectomy and amniotic membrane transplantation. Case summary: A 20-year-old female patient presented with repeated vernal keratoconjunctivitis in both eyes since the age of 14. Despite medical therapy, she developed severe itching, burning and foreign body sensations, and limbal nodules with mutiple giant papillae of the upper tarsal plate. Surgical resection of the giant papillae and amniotic membrane transplantation in her left eye was performed. One month later, the same procedure was performed in her right eye. The patient’s symptoms then improved. Neither recurrence nor serious complication were observed during the 6 months follow up period after surgery. Conclusions: In intractable vernal keratoconjunctivitis, papillectomy with amniotic membrane transplantation may potentially be a good treatment option for better clinical outcome and low recurrence rates.
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