각막육아종이 반복되는 스티븐스-존슨증후군 환자에서 무세포 보존 각막의 층판이식술 효과

초록

Purpose: We describe a patient with Stevens-Johnson syndrome who exhibited recurrent anterior corneal granulomas after corneal perforation (despite multiple amniotic membrane [AM] transplantations); the patient was successfully treated by lamellar grafting of an acellular, preserved human cornea. Case summary: Corneal granulomas developed four times in a 46-year-old man who had been diagnosed with Stevens-Johnson syndrome 17 years priorly and who had undergone multiple AM transplantations after corneal perforation. A corneal granulomatous mass recurred 2 months prior to presentation in our clinic; it rapidly increased in size. With the patient under general anesthesia, the corneal mass was excised and a 4.0-mm-diameter, acellular preserved human cornea (Halo; Eversight Inc., PaloAlto, CA, USA) was grafted. A similarly sized AM was placed over the grafted cornea. Although the engrafted cornea exhibited stromal infiltration 1 month after surgery, the keratitis improved following brief antibiotic treatment. At 8 months postoperatively, the wound was stable; no granuloma recurrence, no graft melting, and no suspected microbial keratitis were observed in the region of the graft. Conclusions: In patients with Stevens-Johnson syndrome and recurrent anterior granulomas (despite multiple AM transplantations), a lamellar graft of acellular, preserved human cornea may be a good therapeutic choice.

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