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严重巩膜凹陷作为单纯结膜闭合翼状胬肉切除术后的早期并发症及文献复习

Severe scleral dellen as an early complication of pterygium excision with simple conjunctival closure and review of the literature.

作者信息

Garcia-Medina Jose Javier, Del-Rio-Vellosillo Mónica, Zanon-Moreno Vicente, Ortiz-Gomariz Amanda, Morcillo-Guardiola Manuela, Pinazo-Duran Maria Dolores

机构信息

Department of Ophthalmology, General University Hospital Reina Sofia, Murcia, Spain.

Department of Anesthesia, University Hospital La Arrixaca, Murcia, Spain.

出版信息

Arq Bras Oftalmol. 2014 May-Jun;77(3):182-4. doi: 10.5935/0004-2749.20140046.

Abstract

We describe a patient with acute scleral dellen (SD) after pterygium excision with simple conjunctival closure. In addition, we present a PUBMED review on the medical literature on early SD after pterygium surgery. This case describes a 45-year-old man who presented with severe SD, 7 days after pterygium surgery with minimal cauterization of episcleral vessels and simple conjunctival closure.No other adjunctive therapy was used intraoperatively. The patient refused conjunctival flap coverage of the lesion. Therefore, medical treatment consisted of antibiotic ointment, patching, and daily follow-up. After 7 days, the patching was changed for intensive ocular lubrication. Five weeks later, the surrounding conjunctive had completely covered the affected sclera. To the best of our knowledge, this is the first report of early SD following pterygium excision and simple conjunctival closure with no other adjunctive therapy. When performing pterygium excision with conjunctival coverage of the sclera, a close follow-upis recommended to rule out wound dehiscence and SD, even when surgical wound closure is considered to prevent

摘要

我们描述了一例在翼状胬肉切除术后单纯结膜闭合而发生急性巩膜裸露(SD)的患者。此外,我们对翼状胬肉手术后早期SD的医学文献进行了PubMed综述。该病例描述了一名45岁男性,在翼状胬肉手术后7天出现严重SD,术中对巩膜表面血管进行了最小程度的烧灼并单纯闭合结膜,未使用其他辅助治疗。患者拒绝用结膜瓣覆盖病变部位。因此,治疗措施包括使用抗生素眼膏、眼部包扎及每日随访。7天后,改为加强眼部润滑并停止包扎。五周后,周围结膜完全覆盖了受累巩膜。据我们所知,这是首例翼状胬肉切除术后单纯结膜闭合且未使用其他辅助治疗而发生早期SD的报告。当进行翼状胬肉切除并采用结膜覆盖巩膜时,即使认为手术伤口闭合可预防,也建议密切随访以排除伤口裂开和SD。

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