Abstract：
BACKGROUND: Neurotrophic keratopathy (NK) is a rare degenerative corneal disease caused by damage to the trigeminal nerve. We hereby describe a severe case with bilateral corneal perforation due to leprosy (Hansen\'s disease)-associated NK.
METHODS: An 89-year-old man with a history of leprosy treated 40 years previously in our sanatorium developed bilateral corneal perforation due to NK. He had a history of bilateral persistent epithelial defects and bacterial keratitis. Although epithelialization was obtained with the use of autologous serum eye drops, progressive corneal thinning concomitant with stromalysis led to bilateral perforation. Over one month treatment with topical antibiotics, anti-inflammatory and lubricants resulted in healing of the epithelial defects and corneal perforations. A Cochet-Bonnet esthesiometer demonstrated a total absence of corneal sensation in both eyes.
CONCLUSIONS: The present case indicated the irreversible nerve damage due to leprosy that had been cured 23 years ago, which can progress over the years and cause bilateral corneal perforations.
METHODS: An 89-year-old man with a history of leprosy treated 40 years previously in our sanatorium developed bilateral corneal perforation due to NK. He had a history of bilateral persistent epithelial defects and bacterial keratitis. Although epithelialization was obtained with the use of autologous serum eye drops, progressive corneal thinning concomitant with stromalysis led to bilateral perforation. Over one month treatment with topical antibiotics, anti-inflammatory and lubricants resulted in healing of the epithelial defects and corneal perforations. A Cochet-Bonnet esthesiometer demonstrated a total absence of corneal sensation in both eyes.
CONCLUSIONS: The present case indicated the irreversible nerve damage due to leprosy that had been cured 23 years ago, which can progress over the years and cause bilateral corneal perforations.
摘要：
背景：神经营养性角膜病变（NK）是一种罕见的由三叉神经损伤引起的退行性角膜疾病。我们在此描述了一个严重的病例，由于麻风病（汉森病）相关的NK引起的双侧角膜穿孔。
方法：40年前在我们的疗养院治疗的一名有麻风病病史的89岁男子由于NK导致双侧角膜穿孔。他有双侧持续性上皮缺损和细菌性角膜炎的病史。尽管使用自体血清滴眼液获得了上皮化，进行性角膜变薄伴随基质透析导致双侧穿孔。用局部抗生素治疗超过一个月，抗炎和润滑剂导致上皮缺损和角膜穿孔的愈合。Cochet-Bonnet美度计显示双眼完全没有角膜感觉。
结论：本病例显示23年前已治愈的麻风病导致的不可逆性神经损伤，这可能会随着多年的发展而导致双侧角膜穿孔。
方法：40年前在我们的疗养院治疗的一名有麻风病病史的89岁男子由于NK导致双侧角膜穿孔。他有双侧持续性上皮缺损和细菌性角膜炎的病史。尽管使用自体血清滴眼液获得了上皮化，进行性角膜变薄伴随基质透析导致双侧穿孔。用局部抗生素治疗超过一个月，抗炎和润滑剂导致上皮缺损和角膜穿孔的愈合。Cochet-Bonnet美度计显示双眼完全没有角膜感觉。
结论：本病例显示23年前已治愈的麻风病导致的不可逆性神经损伤，这可能会随着多年的发展而导致双侧角膜穿孔。
