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A Case of Autologous Tragal Perichondrium Graft in a Patient with Mooren¡¯s Ulcer
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À̵¿ÀÍ(Lee Dong-Ik) - Áß¾Ó´ëÇб³ ÀÇ°ú´ëÇÐ ¾È°úÇб³½Ç
±è°æ¿ì(Kim Kyoung-Woo) - Áß¾Ó´ëÇб³ ÀÇ°ú´ëÇÐ ¾È°úÇб³½Ç
±èÀçÂù(Kim Jae-Chan) - Áß¾Ó´ëÇб³ ÀÇ°ú´ëÇÐ ¾È°úÇб³½Ç
Abstract
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Áõ·Ê¿ä¾à: 49¼¼ ³²ÀÚ È¯ÀÚ°¡ ¹«·»°¢¸·±Ë¾ç Áø´Ü ÇÏ º»¿øÀ¸·Î ÀǷڵǾú´Ù. ³»¿ø½Ã ±Ë¾çÀÌ °¢¸· º¯¿¬ºÎ 360µµ Àüü¸¦ ħ¹üÇÏ°í ÀÖ´Â ¼Ò°ßÀ» º¸¿´À¸¸ç ½Ã·ÂÀº 0.04¿´´Ù. ³»°úÀû Ä¡·á¿¡ ¹ÝÀÀÇÏÁö ¾Ê°í ±Ë¾çÀÌ ±Þ¼ÓÈ÷ ÁøÇàÇÏ´Â ¼Ò°ßÀ» º¸¿© ¼ö¼úÀû Ä¡·á¸¦ °áÁ¤ÇÏ¿´À¸¸ç, ħ¹üµÈ °¢¸·°ú °á¸·À» ÀýÁ¦ÇÏ°í °á¼ÕºÎÀ§¸¦ ÀÚ°¡ ±Í±¸½½ ¿¬°ñ¸·°ú µ¿Á¾ °¢¸· À±ºÎ À̽ļúÀ» ½ÃÇàÇÏ¿© º¹¿øÇÏ¿´´Ù. ¼ö¼ú ÈÄ °¢¸· ±Ë¾çÀÇ ÁøÇàÀº ¸ØÃèÀ¸¸ç ÁÖ°üÀû Áõ»ó ¶ÇÇÑ ¶Ñ·ÇÀÌ È£ÀüµÇ¾ú´Ù. ¼ö¼ú 1ÁÖ ÈÄ À̽ÄÆí À§·Î ºü¸¥ Ç÷°üÇü¼ºÀÌ ÀÌ·ç¾îÁ³´Ù. ±×·¯³ª Á߽ɺΠ°¢¸·ÀÇ È¥Å¹À¸·Î ¼ö¼ú 5°³¿ù µÚ, ÀüÃþ °¢¸· À̽ļúÀ» ½ÃÇàÇÏ¿´À¸¸ç, °¢¸·ÀÌ½Ä ½ÃÇà ÈÄ 6°³¿ù±îÁö Àú¿ë·®ÀÇ Á¡¾È ½ºÅ×·ÎÀ̵å Åõ¿©¸¸À¸·Î °ÅºÎ¹ÝÀÀ ¾øÀÌ °¢¸·ÀÇ Åõ¸í¼ºÀÌ À¯ÁöµÇ¾ú°í À±ºÎ ±â´É ºÎÀü ¼Ò°ßÀº ¾ø¾ú´Ù. ȯÀÚÀÇ ÃÖÁ¾Àû ÃÖ´ë±³Á¤½Ã·ÂÀº 0.125¿´´Ù.
°á ·Ð: ¹«·»°¢¸·±Ë¾çÀÇ ¼ö¼úÀû Ä¡·á¿¡¼ ±Í±¸½½ ¿¬°ñ¸· À̽ÄÀº °á¼ÕºÎÀ§ÀÇ ¼öº¹, µ¿¹Ý À̽ÄÆíÀÇ »ýÂø, °¢¸·ÀÇ ±â´É À¯Áö¿¡ È¿°úÀûÀ̾ú´Ù. µû¶ó¼ °¢¸·À̽ÄÀÇ ¿¹ÈÄ°¡ ºÒ·®ÇÑ È°µ¿¼º ¹«·»°¢¸·±Ë¾ç°ú À±ºÎ ±â´É ºÎÀüÀÌ ¹ß»ý °¡´ÉÇÑ Áúȯ¿¡¼ È¿°úÀûÀÎ Ä¡·á¹ýÀ¸·Î¼ °í·ÁµÉ ¼ö ÀÖÀ» °ÍÀÌ´Ù.
Purpose: To report the effectiveness of an autologous tragal perichondrium graft for an active Mooren¡¯s ulcer.
Case summary: A 49-year-old male was referred to our clinic with Mooren¡¯s ulcer in his left eye. On the first visit, the ulcer involved the entire 360 degrees of the peripheral cornea and the visual acuity was 0.04. As the ulcer did not respond to medical treatment and progressed rapidly, the authors decided on surgical treatment. First, the involved cornea and nearby conjunctiva were removed and the defect was successfully reconstructed with autologous tragal perichondrium and allogenic limbal graft. The progression of corneal ulceration ceased after surgery and the patient¡¯s symptoms remarkably improved. Additionally, the graft showed rapid vascularization and engraftment within a week. However, as the opacity evolved and progressed to the central cornea, penetrating keratoplasty (PKP) was performed 5 months after the perichondrial graft. There was no rejection and corneal translucency was kept clear with low-dose steroid eye drops until 6 months after PKP without any sign of limbal deficiency. The patient¡¯s final best corrected visual acuity was 0.125.
Conclusions: The present study shows that autologous tragal perichondrium graft is an effective method of treatment for active Mooren¡¯s ulcer by defect reconstruction and results in survival of the co-transplanted graft as well as maintaining corneal functions.
Å°¿öµå
Autologus tragal perichondrium graft, Mesenchymal stem cell, Mooren¡¯s ulcer
KMID :
0360220140550030437
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