Hu Chih-Ling, Peng Kai-Ling
Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan,
Int Med Case Rep J. 2018 Jul 27;11:157-159. doi: 10.2147/IMCRJ.S167722. eCollection 2018.
We report a rare case of silicone oil droplets adhering to the posterior surface of an intraocular lens (IOL) after removal of silicone oil for a patient with retinal reattachment, who had a history of pseudophakic rhegmatogenous retinal detachment.
A 45-year-old male with a history of cataract surgeries of both eyes developed pseudophakic retinal detachment in his left eye. He received surgeries of scleral buckle and standard 3-port pars plana vitrectomy with silicon oil tamponade. With retinal attachment for 7 months, he underwent removal of silicone oil in the left eye. However, a big silicone oil droplet was found on the posterior surface of the IOL with complaints of distorted micropsia and poor vision, a month later. Pars plana vitrectomy using a 20-gauge vitreous cutter, which was supposed to have a higher cleaning capability compared with a smaller size device, was performed to aspirate the main part of the big oil droplet. The residual dispersed smaller droplets at the center of the visual axis were swept peripherally using a 27-gauge bending tip cannula. Fortunately, the patient regained his vision of 20/20 without distortion and micropsia in his left eye.
This was a rare case where silicone oil droplets were found adhering to the posterior surface of an IOL after removing silicone oil a month later. We used a 20-gauge vitrectomy system to remove large oil droplets and swept smaller ones off the visual axis to improve the vision and visual quality.
我们报告一例罕见病例,一名有假晶状体孔源性视网膜脱离病史的视网膜复位患者在硅油取出术后,硅油滴附着于人工晶状体(IOL)后表面。
一名45岁男性,双眼有白内障手术史,左眼发生假晶状体性视网膜脱离。他接受了巩膜扣带术和标准三通道经平坦部玻璃体切除术并使用硅油填塞。视网膜复位7个月后,他接受了左眼硅油取出术。然而,一个月后,在人工晶状体后表面发现一个大的硅油滴,患者主诉有视物变形和视力不佳。使用20号玻璃体切割器进行经平坦部玻璃体切除术,该切割器与较小尺寸的设备相比,被认为具有更高的清洁能力,以吸出大油滴的主要部分。使用27号弯曲头套管将视轴中心残留的分散较小油滴扫至周边。幸运的是,患者左眼恢复了20/20的视力,且无变形和视物变小。
这是一例罕见病例,在硅油取出一个月后,发现硅油滴附着于人工晶状体后表面。我们使用20号玻璃体切除系统去除大油滴,并将较小油滴从视轴上扫出,以改善视力和视觉质量。