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玻璃体切割术中硅油注入时的巩膜破裂

Scleral rupture during intraoperative silicone oil injection in pars plana vitrectomy.

作者信息

Domínguez Yates Ana Laura, Rojas Jimena, Saravia Mario Joaquín

机构信息

Hospital Universitario Austral, Avenida Presidente Perón 1500, Derqui, Pilar, Buenos Aires, 1629, Argentina.

出版信息

Am J Ophthalmol Case Rep. 2019 Jun 29;15:100506. doi: 10.1016/j.ajoc.2019.100506. eCollection 2019 Sep.

Abstract

PURPOSE

To report a single case history of scleral rupture (SR) during silicone oil injection in a pars plana vitrectomy.

OBSERVATIONS

A 60-year-old woman with a history of pathological myopia presented with acute vision loss in her right eye. A retinal detachment, with multiple tears, was diagnosed, and she underwent vitreoretinal surgery. During silicone oil injection, a SR, with extra ocular oil leakage, was advised. Due to the small extent of the lacerated area, the SR was left to spontaneously resolve and, after three surgeries, the retina remained attached, with no internal tamponade, and the patient had not presented symptoms or signs of intracranial migration or toxicity.

CONCLUSIONS AND IMPORTANCE

During silicone oil injection, it is most important to maintain a controlled eyeball pressure, especially in patients with scleral weakness, and to carefully check the drainage of air, due to the risk of SR. When oil leakage is detected in the orbital cavity, an accurate assessment may be required due to the likelihood of progression inside the intracranial structures.

摘要

目的

报告1例在玻璃体切割术中硅油注射时发生巩膜破裂(SR)的病例史。

观察结果

一名有病理性近视病史的60岁女性右眼出现急性视力丧失。诊断为视网膜脱离伴多处裂孔,她接受了玻璃体视网膜手术。在硅油注射过程中,发生了SR,并伴有眼外硅油渗漏。由于撕裂区域范围较小,巩膜破裂未作处理,任其自行愈合。经过三次手术后,视网膜仍然附着,未进行内填充,患者未出现颅内迁移或毒性的症状或体征。

结论与重要性

在硅油注射过程中,保持眼球压力可控非常重要,尤其是对于巩膜薄弱的患者,并且由于存在SR风险,要仔细检查空气引流情况。当在眶腔内检测到硅油渗漏时,由于硅油可能在颅内结构内进展,可能需要进行准确评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/54ac/6609831/b1abc267c87a/gr1.jpg

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