垂直直肌手术后的眼前节缺血和视网膜脱离
Anterior segment ischemia and retinal detachment after vertical rectus muscle surgery.
作者信息
Wolf E, Wagner R S, Zarbin M A
机构信息
Department of Ophthalmology, New Jersey Medical School, University of Medicine and Dentistry of New Jersey, Newark 07103-2499, USA.
出版信息
Eur J Ophthalmol. 2000 Jan-Mar;10(1):82-7.
PURPOSE
The authors describe the clinical course of a woman who developed two complications following vertical strabismus repair: anterior segment ischemia (ASI) and retinal detachment.
METHODS
A 62 year-old woman is described. She presented with new onset proptosis and left hypertropia with significant diplopia in all fields of gaze. This presentation, her 15 year history of thyroid disease, and preoperative computed tomography (CT) of the orbits were consistent with Graves' ophthalmopathy. Vertical strabismus repair was carried out by recessing the left superior rectus muscle and resecting the left inferior rectus muscle.
RESULTS
The diplopia was eliminated. The patient developed significant postoperative ASI and iatrogenic rhegmatogenous retinal detachment in the left eye due to unsuspected globe perforation. She was treated with systemic corticosteroids and radial scleral buckling.
CONCLUSIONS
Severe ASI following strabismus surgery is a well recognized complication, with age, thyroid ophthalmopathy, and manipulation of the vertical rectus muscles as risk factors. The retinal detachment soon after strabismus surgery was difficult to detect, possibly due to diminished visualization of the posterior segment as a result of ASI.
目的
作者描述了一名女性在垂直斜视修复术后出现两种并发症的临床过程：眼前段缺血（ASI）和视网膜脱离。
方法
描述了一名62岁女性。她出现新发眼球突出和左眼上斜视，在所有注视方向均有明显复视。这种表现、她15年的甲状腺疾病史以及术前眼眶计算机断层扫描（CT）与格雷夫斯眼病相符。通过后徙左直肌和切除左眼下直肌进行垂直斜视修复。
结果
复视消除。患者术后因未被察觉的眼球穿孔出现严重的术后ASI和左眼医源性孔源性视网膜脱离。她接受了全身皮质类固醇治疗和放射状巩膜扣带术。
结论
斜视手术后严重的ASI是一种公认的并发症，年龄、甲状腺眼病和垂直直肌的操作是危险因素。斜视手术后不久出现的视网膜脱离很难检测到，可能是由于ASI导致后段可视化减弱。
Zotero 插件