Ünsal Erkan, Eltutar Kadir, Kızılay Osman, Karini Belma
İstanbul Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey.
Zeynep Kamil Women's and Children's Hospital Training and Research Hospital, Ophthalmology Clinic, İstanbul, Turkey.
Turk J Ophthalmol. 2016 Dec;46(6):293-295. doi: 10.4274/tjo.88864. Epub 2016 Dec 1.
A 56-year old female patient presented to our clinic with a complaint of low vision in her right eye. Twenty-two years earlier she had undergone a scleral buckling operation in her right eye because of retinal detachment. She indicated that vision in her right eye was good after the surgery but had recently been gradually declining. Best-corrected vision acuity was counting fingers at 1 meter in the right eye and 8/10 in the left eye. Anterior segment examination revealed stage 3 nuclear cataract in the right eye. Examination of the right eye was blurred and revealed an area of chorioretinal atrophy posterior to the equator, approximately 3 disc diameters in the peripapillary zone and about 2 disc diameters in the nasal papilla zone. Anteriorly of the equator there was an area of chorioretinal atrophy as well as a narrow, sharply demarcated, shiny 360⁰ suture with high buckling pressure, situated intraretinally but extending into the vitreous in some places. The structure was thought to be made of polyethylene. Around the suture there were retinal atrophic changes. After detailed explanation of the possible surgical complications and after obtaining informed consent, the right eye cataract was removed by phacoemulsification and a foldable intraocular lens was placed into the capsule. During the operation, we worked under low fluid pressure and as atraumatically as possible due to the possibility of intraocular pressure changes and the risk of the suture causing retinal and blood vessel tears or passing completely into the eye and causing intravitreal hemorrhage. A month after an uncomplicated surgery, the posterior segment examination demonstrated a reattached retina and the patient's best corrected visual acuity was 6/10.
一名56岁女性患者因右眼视力低下前来我院就诊。22年前，她因视网膜脱离在右眼接受了巩膜扣带手术。她表示术后右眼视力良好，但最近逐渐下降。右眼最佳矫正视力为1米处数指，左眼为8/10。眼前节检查发现右眼为3期核性白内障。右眼检查模糊，赤道后方可见脉络膜视网膜萎缩区域，视乳头周围区域约为3个视盘直径，鼻侧视乳头区域约为2个视盘直径。赤道前方也有脉络膜视网膜萎缩区域，以及一条狭窄、边界清晰、闪亮的360⁰缝线，扣带压力高，位于视网膜内，但在某些地方延伸至玻璃体。该结构被认为是由聚乙烯制成。缝线周围有视网膜萎缩改变。在详细解释了可能的手术并发症并获得知情同意后，通过超声乳化术摘除了右眼白内障，并将一枚可折叠人工晶状体植入囊袋内。手术过程中，由于存在眼压变化的可能性以及缝线导致视网膜和血管撕裂或完全进入眼内并引起玻璃体积血的风险，我们在低眼压下尽可能轻柔地操作。在无并发症的手术后一个月，眼后节检查显示视网膜复位，患者最佳矫正视力为6/10。
