Choudhary Samiksha, Sen Swarnali, Gupta Omprakash
Venu Eye Institute and Research Centre, New Delhi, India.
Oman J Ophthalmol. 2018 Jan-Apr;11(1):52-54. doi: 10.4103/ojo.OJO_121_2016.
We report an unusual case of granulomatous inflammation that presented adjacent to bleb 3 weeks postoperatively after combined phacoemulsification and trabeculectomy surgery with mitomycin-C due to retained microfragments of methyl cellulose sponge. The commonly used antimetabolite delivery devices are made of cellulose. Methyl cellulose sponges are friable, and they are likely to leave behind microfragments in subconjunctival space. In our case, bleb integrity was maintained, unlike the earlier reported cases which presented with bleb leak. Hence, one should have high index of suspicion in unusual cases of postoperative inflammation not resolving conservatively. Although rare, retained sponge particles can be a cause of early bleb-related inflammation which can lead to bleb failure.
我们报告了一例罕见的肉芽肿性炎症病例，该病例发生在白内障超声乳化吸除联合小梁切除术并使用丝裂霉素-C治疗后3周，因甲基纤维素海绵的微小碎片残留于滤过泡附近。常用的抗代谢药物输送装置由纤维素制成。甲基纤维素海绵质地脆，很可能在结膜下间隙留下微小碎片。在我们的病例中，滤过泡的完整性得以维持，这与早期报道的出现滤过泡渗漏的病例不同。因此，对于保守治疗后仍未消退的术后炎症的异常病例，应保持高度怀疑。尽管罕见，但残留的海绵颗粒可能是早期滤过泡相关炎症的一个原因，进而可能导致滤过泡失败。
