METHODS: A 22-year-old female presented with bilateral VKC with total LSCD. A thick fibrotic pannus was present in both eyes, with visual axis involvement in the right eye. The central cornea in the left eye was clear. The patient underwent a cadaveric allo-SLET in the right eye to restore the ocular surface. Systemic immunosuppression with oral cyclosporine was administered following the surgery. The corrected visual acuity with scleral contact lenses (SCL) was 20/20 in both eyes which was maintained until the last follow-up visit, one year after the surgery. No recurrence of LSCD was observed in the right eye and the ocular surface was well epithelialized.
CONCLUSIONS: Allo-SLET is a simple and efficacious surgical technique for bilateral LSCD. Eyes with VKC have a wet ocular surface, relatively clear corneal stroma, and minimal adnexal involvement. Thus, allo-SLET is the ideal procedure to address LSCD in such cases. The systemic immunosuppression that is given for ensuring graft survival can also help control the underlying allergy. Scleral contact lenses improve the visual acuity and their long-term usage does not affect the functioning of the SLET transplants.
CONCLUSIONS: VKC with bilateral LSCD can be successfully managed with allogeneic SLET. Post-operative systemic immunosuppressants are essential to maintain viable grafts. The use of SCL can improve vision and they do not pose any risk to the SLET transplants.
方法:一名22岁女性患者表现为双侧VKC伴总LSCD。两只眼睛都出现了厚厚的纤维化血管造影,视轴受累于右眼。左眼中央角膜是透明的。患者在右眼中接受尸体同种异体SLET以恢复眼表。手术后给予口服环孢菌素的系统性免疫抑制。巩膜隐形眼镜(SCL)的矫正视力在两只眼睛为20/20,一直保持到最后一次随访,手术后一年.在右眼中未观察到LSCD的复发,并且眼表上皮化良好。
结论:Allo-SLET是治疗双侧LSCD的一种简单有效的手术技术。带有VKC的眼睛有湿润的眼表,相对清晰的角膜基质,和最少的附件参与。因此,在这种情况下,allo-SLET是解决LSCD的理想程序。为确保移植物存活而给予的全身性免疫抑制也可以帮助控制潜在的过敏。巩膜隐形眼镜可改善视力,长期使用不会影响SLET移植的功能。
结论:VKC伴双侧LSCD可通过同种异体SLET成功治疗。术后全身免疫抑制剂对于维持可行的移植物至关重要。SCL的使用可以改善视力,并且对SLET移植没有任何风险。