Department of Ophthalmology, Stanford University, Stanford, CA 94305-5308, USA.
J Glaucoma. 2011 Apr-May;20(4):244-5. doi: 10.1097/IJG.0b013e3181e3d0cd.
To report a case of extensive intrastromal corneal infiltration with opacification after compression suture placement for hypotony maculopathy.
Retrospective case report.
A 24-year-old Indian male with hypotony maculopathy after trabeculectomy was referred to us for management of overfiltration. Compression sutures were placed to reduce bleb size and area of filtration. Slit lamp photographs and bleb/corneal imaging with anterior segment optical coherence tomography were performed to document corneal infiltration.
After placement of the compression sutures in an attempt to delimit the large bleb, there was normalization of the intraocular pressure and improvement in visual acuity. However, the patient developed a wide area of corneal intrastromal deposition that did not extend into the visual axis and was not visually significant. The intrastromal location of the infiltration was delineated on cross-sectional anterior segment optical coherence tomography imaging.
The placement of compression sutures near the scleral flap may create upward tension that we hypothesize can lead to subsequent corneal intrastromal deposition. Despite this rare complication, compression sutures remain a good option for the treatment of an overfiltering bleb.
报告 1 例因压迫缝线放置后导致低眼压性黄斑病变而出现广泛基质内角膜浸润和混浊的病例。
回顾性病例报告。
1 例 24 岁印度男性,因小梁切除术导致低眼压性黄斑病变,来我院就诊,以治疗过度滤过。放置压迫缝线以缩小滤泡大小和滤过面积。使用裂隙灯照相和眼前节光学相干断层扫描对角膜浸润进行记录。
在试图限制大滤泡的情况下放置压迫缝线后,眼内压正常化,视力提高。然而,患者出现了广泛的基质内角膜沉积,未延伸至视轴,也不影响视力。通过横断面眼前节光学相干断层扫描成像描绘了浸润的基质内位置。
压迫缝线靠近巩膜瓣的放置可能会产生向上的张力,我们推测这可能导致随后的角膜基质内沉积。尽管存在这种罕见的并发症,但压迫缝线仍然是治疗过度滤过滤泡的一个不错的选择。