Grünauer-Kloevekorn Claudia, Krause Albrecht, Duncker Gernot I W
Klinik und Poliklinik für Augenheilkunde der Martin-Luther-Universität Halle-Wittenberg.
Klin Monbl Augenheilkd. 2004 Jan;221(1):56-8. doi: 10.1055/s-2003-812640.
Several early and late complications have been described since the introduction of cerclage surgery using a supramid suture. Due to cutting of the supramid suture through scleral tissue the supramid suture may appear at the fundus. Long-term results of scleral penetration and crossing the bulbus by the supramid suture, which is then only covered by the retina ("clothesline phenomenon"), could not be described so far. We report on a patient 20 years after cerclage surgery with Arruga's suture.
A now 63-year old female patient with high myopia (D - 14.0 OU) suffering from complete retinal detachment had had ophthalmic surgery using Arruga's encircling suture with additional horizontal buckling at her left eye in 1983. Postoperative visual acuity was 10/20. The retina was attached. In 2002 phakoemulsification with posterior chamber lens implantation due to cataracta corticalis was done externally. In 2003 a complete scleral and chorioidal penetration and appearance of the Arruga's suture behind the retina occurred extending from 4 over 6 to 8 o'clock position with a visual acuity of 20/25. The patient did not agree with the cutting of the suture at any time.
The "clothesline phenomenon" is a very rare late complication after encircling surgery using an Arruga suture by retinal detachment. Suture cutting is suggested because of a possible risk of retinal detachment. As shown in our case report, stable retinal attachment after Arruga's suturing is possible.
自从采用聚丙烯酰胺缝线进行环扎手术以来，已经描述了几种早期和晚期并发症。由于聚丙烯酰胺缝线穿过巩膜组织，聚丙烯酰胺缝线可能出现在眼底。到目前为止，还无法描述聚丙烯酰胺缝线穿透巩膜并穿过眼球，仅被视网膜覆盖（“晾衣绳现象”）的长期结果。我们报告一例采用阿鲁加缝线进行环扎手术后20年的患者。
一名63岁的女性高度近视患者（双眼近视度数为-14.0D），患有完全性视网膜脱离，于1983年在左眼接受了使用阿鲁加环扎缝线并附加水平加压的眼科手术。术后视力为10/20。视网膜复位。2002年因皮质性白内障行白内障超声乳化吸除联合后房型人工晶状体植入术。2003年，出现了完全性巩膜和脉络膜穿透，阿鲁加缝线出现在视网膜后方，从4点延伸至6点至8点位置，视力为20/25。患者在任何时候都不同意剪断缝线。
“晾衣绳现象”是视网膜脱离采用阿鲁加缝线环扎手术后一种非常罕见的晚期并发症。由于存在视网膜脱离的潜在风险，建议剪断缝线。如我们的病例报告所示，采用阿鲁加缝线后视网膜可以稳定复位。
