[A case of lamellar keratoplasty and autoscleroplasty combined with keratoepithelioplasty for Wegener's sclerocorneal ulcer].
A 62-year-old man with Wegener's granulomatosis developed sclerocorneal ulcer. The general condition of the patient became well with steroid and presented cyclophosphamide therapy, he developed sclerocorneal ulcer. The sclerocorneal ulcer was present at the nasal limbus of the right eye. The ulcer was marked and presented descemetocele. Although lamellar keratoplasty was performed, the scleral ulcer recurred after two weeks. Excision of the affected sclera and autoscleroplasty was performed. The ulcer disappeared after 6 months, and the corneal graft was covered with corneal epithelium and conjunctiva. Ten months after autoscleroplasty was performed, a sclerocorneal ulcer was again recurred. We performed lamellar excision of the affected corneal area, resected the adjacent conjunctiva and performed keratoepithelioplasty. These surgical procedures were effective in preventing perforation of the cornea. Specular microscopic study of the corneal epithelium revealed nucleated epithelium and large epithelial cells. The endothelium appeared normal.
Saito
N
N
First Department of Ophthalmology, Toho University School of Medicine, Ota-ku, Japan.
Mori
T
T
Kubota
Y
Y
Tochikubo
T
T
Matsuhashi
M
M
Komoto
M
M
D016039:Corneal Transplantation; D003320:Corneal Ulcer / Q000209:etiology / Q000601:surgery*; D004848:Epithelium / Q000637:transplantation; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012590:Sclera / Q000637:transplantation*; D015422:Scleral Diseases / Q000209:etiology / Q000601:surgery*; D016639:Scleroplasty / Q000379:methods; D014182:Transplantation, Autologous; D014456:Ulcer / Q000209:etiology / Q000601:surgery