大量硅油迁移至结膜下间隙：渗漏机制困境
Massive Silicone Oil Migration into the Subconjunctival Space: A Leakage Mechanism Dilemma.
作者信息
Téllez Jesús, Vela José I, Luna Sabina, Delgado Rubén
机构信息
Department of Ophthalmology, Hospital de la Santa Creu i de Sant Pau, Autonoma University of Barcelona, Barcelona, Spain.
Departament of Ophthalmology, Grupo Admiravisión, Barcelona, Spain.
出版信息
Case Rep Ophthalmol. 2018 May 31;9(2):310-314. doi: 10.1159/000487982. eCollection 2018 May-Aug.
PURPOSE
To report a case in which an early, massive silicone oil migration into the subconjunctival space occurred in a patient after sutureless vitrectomy with the presence of a previously implanted pars plana glaucoma drainage device.
CASE REPORT
An 80-year-old man presented with neovascular glaucoma secondary to a proliferative diabetic retinopathy in his left eye. After an intracamerular bevacizumab injection and panretinal photocoagulation, a 23-gauge pars plana vitrectomy (PPV) combined with a superotemporal Ahmed pars plana glaucoma valve implantation was performed. Afterwards, the patient underwent a new 23-gauge PPV for a dense vitreous hemorrhage. Intravitreal 1,000 centistokes silicone oil was placed to prevent recurrent intraocular bleeding. No sutures were performed. In the first postoperative month, a massive migration of silicone oil into the 360° subconjunctival space was noted until no intraocular silicone oil was observed.
CONCLUSIONS
We discuss the possible leakage mechanisms in this particular case.
目的
报告一例在无缝线玻璃体切除术后早期大量硅油迁移至结膜下间隙的病例，该患者此前植入了睫状体平坦部青光眼引流装置。
病例报告
一名80岁男性，左眼因增殖性糖尿病视网膜病变继发新生血管性青光眼。在进行前房内注射贝伐单抗和全视网膜光凝后，实施了23G睫状体平坦部玻璃体切除术（PPV）并联合颞上方艾哈迈德睫状体平坦部青光眼瓣膜植入术。之后，该患者因严重玻璃体积血接受了新的23G PPV。向玻璃体内注入1000厘沲硅油以预防复发性眼内出血。未进行缝合。术后第一个月，观察到硅油大量迁移至360°结膜下间隙，直至眼内未再观察到硅油。
结论
我们讨论了该特殊病例中可能的渗漏机制。
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