Duch Susana, Milla Elena, Stirbu Oana, Andreu David
ICO - Instituto Condal de Oftalmología, Barcelona, Spain.
Case Rep Ophthalmol. 2016 Sep 16;7(3):132-137. doi: 10.1159/000447528. eCollection 2016 Sep-Dec.
To describe the histopathology of non-valved implant capsules in three cases of persistent postoperative hypotony after the restrictive tube ligature was released in patients receiving immunosuppressive therapy.
The macroscopic appearance of the capsules 3 and 4 months postoperatively was immature and loose. Microscopic examination disclosed extremely irregular thin tissue, with thicknesses ranging from 0.02 to 0.6 mm, depending on the capsular location studied. Withdrawal of immunosuppressive therapy did not facilitate rebuilding of new capsules. Replacement with a valved implant device was necessary in two cases; the third case recovered with tapering of prednisone.
The use of chronic systemic immunosuppressive therapy might interfere with capsular formation around the plates of drainage devices inducing persistent hypotony. In these cases, the use of valved implants might be safer.
描述在接受免疫抑制治疗的患者中，限制性引流管结扎松解术后出现持续性术后低眼压的3例患者非带瓣植入物包膜的组织病理学特征。
术后3至4个月，包膜的宏观外观不成熟且松弛。显微镜检查显示组织极其不规则且薄，厚度从0.02毫米到0.6毫米不等，具体取决于所研究的包膜位置。停用免疫抑制治疗并未促进新包膜的重建。2例患者需要更换为带瓣植入装置；第3例患者通过逐渐减少泼尼松剂量而康复。
长期全身性免疫抑制治疗可能会干扰引流装置周围包膜的形成，导致持续性低眼压。在这些情况下，使用带瓣植入物可能更安全。
