Transplante de córnea no tratamento de ceratite micótica pós ceratotomia radial: relato de 3 casos

Sousa, Luciene Barbosa de; Cronemberger, Mônica Fialho; Campos, Mauro; Nosé, Walton

doi:10.5935/0004-2749.19950091

RESUMO

Os autores relatam 3 casos de transplante de córnea em olhos com ceratite micótica pós ceratotomia radial, com evolução satisfatória em um seguimento médio de 28 meses. Os agentes isolados foram Fusarium solani, Acremonium spp e Aspergillus spp. São lembrados alguns aspectos da cicatrização corneana bem como a importância do esclarecimento dos pacientes candidatos à ceratotomia radial quanto à possibilidade da ocorrência de complicações sérias no pós-operatório.

Palavras-chave:
Ceratotomia radial; Infecção micótica; Transplante a quente

SUMMARY

Although radial keratotomy is a simple surgical procedure, a number of serious complications has been reported after it. In this paper, we describe three patients who had undergone radial keratotomy and developed postoperative micotic keratitis. The fungal agents isolated were Acremonium sp, Aspergillus sp and Fusarium solani. Besides the medical therapy, all cases required penetrant keratoplasty for resolution of the disease with good results (average follow up of 28 months). We discuss some aspects of the corneal healing process and the importance of advising patients about complications of radial keratotomy such as infectious keratitis.

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REFERÊNCIAS BIBLIOGRÁFICAS

¹
SATO, T. - Posterior incision of córnea: surgical treatment for conical cornea and astigmatism. Am. J. Ophthalmol., 33: 943-48, 950.
²
FYODOROV, S. N. & DURNEV, V.V. - Operation of dosaged dissection of corneal circular ligament in cases of myopia of mild degree. Ann. Ophthalmol., 11: 1885-90, 1979.
³
BORES, L. D.; MYERS, W. & COWDEN, J. - Radial keratotomy: an analysis of the American experience. Ann. Ophthalmol., 13: 941-48, 1981.
⁴
GELENDER, H.; FLYNN, H. W. J. & MALDELBAUM, S. H. - Bacterial endophthalmitis resulting from radial keratotomy. Am. J. Ophthalmology, 93: 323-26, 1982.
⁵
ROBIN, J. B.; BEATHY, R. F.; DUNN J.; TROUSDALE, M. D.; RUFFENBURGH, R.; RAO, NARSING & SMITH, R. E. - Mycobacterium chelonei keratitis after radial keratotomy. Am. J. Ophthalmology, 102: 72-79, July, 1986.
⁶
WARING, G. O. I. I. I.; LYNN, M. J. & GELENDER, H. - Results of the prospective evaluation of radial keratotomy (PERK) study one year after surgery. Ophthalmology, 92: 177-98, 1985.
⁷
SCHANZLIN, D. J.; SANTOS, U. R. & WARING, G. O. I. I. I. - Diurnal change in refraction corneal curvature, visual acuity, and intra-ocular pressure after radial keratotomy in the PERK study. Ophthalmology, 93: 167-75, 1986.
⁸
GELENDER, H. & GELBER, E. C. - Cataract following radial keratotomy. Arch. Opthalmol., vol. 101, Aug., 1983.
⁹
ROWSEY, J. J.; BALYEAT, H. D. - Preliminary results and complications of radial keratotomy. Am. J. Ophthalmol., 93: 437-55, 1982.
¹⁰
SALZ, J. J. - Progressive endotelial cell loss following radial keratotomy: a case report. Ophthalmic. Surg., 13: 997-999, 1982.
¹¹
LARSON, B.C.; KREMER, F.B.; ELLER, A.W. et al. - Quantitated trauma following radial keratotomy in rabbits. Ophthalmology, 90: 660-7, 1983.
¹²
BECHARA, S. J.; SÁ, L. C. F.; JOSÉ, N. K. & ARIETA, C. E. L. - Trauma perfurante após ceratotomia radial: relato de dois casos. Arq. Bras. Oftal., 54(6): 262-64, 1991.
¹³
RASHID, E. R. & WARING, G. O. - Complications of radial and transverse keratotomy. Survey of Ophthalmology, 34(2): 73-106, 1989.
¹⁴
WILHELMUS, K. R. & HAMBURG, S. - Bacterial keratitis following radial keratotomy. Cornea, 2: 143-46, 1983.
¹⁵
McCLELLAN, K. A.; BERNARD, P. J.; GREGORY-ROBERTS, J. C. E BILLSON, F. A. - Suppurative keratitis: a late complication of radial keratotomy. J. Cataract Refract Surg., 14: 317-20, 1988.
¹⁶
LEWICKY, A. & SALZ, J. - Special report: radial keratotomy survey. J. Refract. Surg., 2: 32-33, 1986.
¹⁷
MANDELBAUM, S.; WARRING, G. O.; FOISHER, R. K.; CULBERTSON, W. W.; ROWSENY, J. J. & ESPINAL, M. E. - Late development of ulcerative keratitis in radial keratotomy scars. Arc. Opthalmol., 104: 1156-60, Aug. 1986.
¹⁸
MASKIN, S. L.; ALFONSO, E. - Fungal keratitis after radial keratoplasty. Am. J. Ophthalmol., 114: 369-70, 1992.

Datas de Publicação

Publicação nesta coleção
Feb 1995

Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que o trabalho original seja corretamente citado.

[1] ¹
SATO, T. - Posterior incision of córnea: surgical treatment for conical cornea and astigmatism. Am. J. Ophthalmol., 33: 943-48, 950.

[2] ²
FYODOROV, S. N. & DURNEV, V.V. - Operation of dosaged dissection of corneal circular ligament in cases of myopia of mild degree. Ann. Ophthalmol., 11: 1885-90, 1979.

[3] ³
BORES, L. D.; MYERS, W. & COWDEN, J. - Radial keratotomy: an analysis of the American experience. Ann. Ophthalmol., 13: 941-48, 1981.

[4] ⁴
GELENDER, H.; FLYNN, H. W. J. & MALDELBAUM, S. H. - Bacterial endophthalmitis resulting from radial keratotomy. Am. J. Ophthalmology, 93: 323-26, 1982.

[5] ⁵
ROBIN, J. B.; BEATHY, R. F.; DUNN J.; TROUSDALE, M. D.; RUFFENBURGH, R.; RAO, NARSING & SMITH, R. E. - Mycobacterium chelonei keratitis after radial keratotomy. Am. J. Ophthalmology, 102: 72-79, July, 1986.

[6] ⁶
WARING, G. O. I. I. I.; LYNN, M. J. & GELENDER, H. - Results of the prospective evaluation of radial keratotomy (PERK) study one year after surgery. Ophthalmology, 92: 177-98, 1985.

[7] ⁷
SCHANZLIN, D. J.; SANTOS, U. R. & WARING, G. O. I. I. I. - Diurnal change in refraction corneal curvature, visual acuity, and intra-ocular pressure after radial keratotomy in the PERK study. Ophthalmology, 93: 167-75, 1986.

[8] ⁸
GELENDER, H. & GELBER, E. C. - Cataract following radial keratotomy. Arch. Opthalmol., vol. 101, Aug., 1983.

[9] ⁹
ROWSEY, J. J.; BALYEAT, H. D. - Preliminary results and complications of radial keratotomy. Am. J. Ophthalmol., 93: 437-55, 1982.

[10] ¹⁰
SALZ, J. J. - Progressive endotelial cell loss following radial keratotomy: a case report. Ophthalmic. Surg., 13: 997-999, 1982.

[11] ¹¹
LARSON, B.C.; KREMER, F.B.; ELLER, A.W. et al. - Quantitated trauma following radial keratotomy in rabbits. Ophthalmology, 90: 660-7, 1983.

[12] ¹²
BECHARA, S. J.; SÁ, L. C. F.; JOSÉ, N. K. & ARIETA, C. E. L. - Trauma perfurante após ceratotomia radial: relato de dois casos. Arq. Bras. Oftal., 54(6): 262-64, 1991.

[13] ¹³
RASHID, E. R. & WARING, G. O. - Complications of radial and transverse keratotomy. Survey of Ophthalmology, 34(2): 73-106, 1989.

[14] ¹⁴
WILHELMUS, K. R. & HAMBURG, S. - Bacterial keratitis following radial keratotomy. Cornea, 2: 143-46, 1983.

[15] ¹⁵
McCLELLAN, K. A.; BERNARD, P. J.; GREGORY-ROBERTS, J. C. E BILLSON, F. A. - Suppurative keratitis: a late complication of radial keratotomy. J. Cataract Refract Surg., 14: 317-20, 1988.

[16] ¹⁶
LEWICKY, A. & SALZ, J. - Special report: radial keratotomy survey. J. Refract. Surg., 2: 32-33, 1986.

[17] ¹⁷
MANDELBAUM, S.; WARRING, G. O.; FOISHER, R. K.; CULBERTSON, W. W.; ROWSENY, J. J. & ESPINAL, M. E. - Late development of ulcerative keratitis in radial keratotomy scars. Arc. Opthalmol., 104: 1156-60, Aug. 1986.

[18] ¹⁸
MASKIN, S. L.; ALFONSO, E. - Fungal keratitis after radial keratoplasty. Am. J. Ophthalmol., 114: 369-70, 1992.

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