RESUMO
The article presents a case of severe purulent corneal ulcer in the only functional eye of a young patient with Frank-Kamenetsky glaucoma and high-degree myopia. Combination therapy was ineffective and the patient developed a descemetocele. Due to the absence of cadaver corneas and small size of the only available conserved Alloplant cornea, the contralateral cornea (of the blind eye, which was enucleated under general anesthesia) was used for urgent therapeutic penetrating autokeratoplasty. Postoperative period was complicated with ocular hypertension, which was surgically resolved. To overcome the critical situation around keratoplasty, with results from Russian regulation gaps, the authors suggest creating interregional eye banks in large cities that would provide sampling, conservation and storage control of donor material in accordance with the existing legislation.
Assuntos
Úlcera da Córnea/cirurgia , Lâmina Limitante Posterior , Ceratoplastia Penetrante , Hipertensão Ocular , Complicações Pós-Operatórias/cirurgia , Transplante Autólogo , Adulto , Cegueira/complicações , Úlcera da Córnea/complicações , Úlcera da Córnea/diagnóstico , Úlcera da Córnea/etiologia , Úlcera da Córnea/fisiopatologia , Lâmina Limitante Posterior/patologia , Lâmina Limitante Posterior/cirurgia , Técnicas de Diagnóstico Oftalmológico , Glaucoma/complicações , Humanos , Ceratoplastia Penetrante/efeitos adversos , Ceratoplastia Penetrante/métodos , Masculino , Miopia/complicações , Hipertensão Ocular/etiologia , Hipertensão Ocular/cirurgia , Reoperação , Índice de Gravidade de Doença , Supuração , Transplante Autólogo/efeitos adversos , Transplante Autólogo/métodos , Resultado do TratamentoRESUMO
The authors present their own clinical experience in three HIV-infected patients with cytomegalovirus retinitis aged from 8 to 36 years. Detailed analysis of the results of physical and laboratory examinations is provided. Given short life expectancy for these patients, the authors pose a deontological question as to whether or not active treatment of retinal detachment in patients with AIDS and CMV retinitis is reasonable.
