Cabric Emir, Jusufovic Vahid, Salihefendic Nizama, Vodencarevic Amra Nadarevic
Public Health Care Institution Doboj-Jug, Matuzići, Bosnia and Herzegovina.
Eye Clinic, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.
Med Arch. 2017 Jun;71(3):226-228. doi: 10.5455/medarh.2017.71.226-228.
It is known that phacoemulsification of cataracts after penetrating keratoplasty there are always some difficulties and of course a higher rate of different intraoperative complications. Phacoemulsification after PK may cause significant endothelial injury and affect long term graft survival.
The aim of this report is to describe one of these cases and the possible ways to manage them.
We report a case o of a 31-year-old female patient, with a cataract on her left eye. She reported that when she was 10 years old, she was admitted to regional hospital in Bosnia and Herzegovina due perforative corneal war injury. At the age of 11 years at Germany on her left eye corneal transplantation was performed. She reported that she wasn't ever seeing quite good, due high myopia. Twenty years after war injury she was admitted to hospital. At that moment patient has been ophthalmologicaly examined (visual acuity testing, biomicroscopy, tonometry, ultrasound of both eyes with biometry and ophthalmoscopy). At the day of admission to the hospital on slit lamp we found occlusion of pupil and complicated cataract. Her only wish was to get operated due cosmetic reasons. Before surgery her visual acuity on her left eye was light perception. Thirty days after surgery her visual acuity was 0,1 without correction.
It is concluded that cataract surgery in patients after keratoplasty is more complicated. Therefore, these patients should be managed with utmost care and operated by an experienced surgeon.
众所周知,穿透性角膜移植术后进行白内障超声乳化手术总会存在一些困难,当然术中出现不同并发症的几率也更高。穿透性角膜移植术后进行超声乳化手术可能会导致严重的内皮损伤,并影响移植片的长期存活。
本报告旨在描述其中一例病例以及处理这些病例的可能方法。
我们报告一例31岁女性患者,左眼患有白内障。她报告说,10岁时因角膜穿孔性战伤入住波斯尼亚和黑塞哥维那的地区医院。11岁时在德国接受了左眼角膜移植手术。她表示由于高度近视,视力一直不太好。战伤20年后她入院治疗。当时对患者进行了眼科检查(视力测试、生物显微镜检查、眼压测量、双眼超声生物测量和检眼镜检查)。入院当天在裂隙灯下我们发现瞳孔闭锁和复杂白内障。她唯一的愿望是出于美容原因接受手术。手术前她左眼的视力为光感。术后30天,她的视力在未矫正的情况下为0.1。
得出的结论是,角膜移植术后患者的白内障手术更为复杂。因此,应对这些患者给予 utmost care,并由经验丰富的外科医生进行手术。 (原文中utmost care表述有误,可能是utmost应为utmost,推测正确表述为“utmost care”为“极度小心”)