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板层巩膜切开术后坏死性巩膜炎。

Necrotising Scleritis following Pars Plana Vitrectomy.

机构信息

Uvea, Neoretina Eyecare Institute , Hyderabad, India.

Microbiology, GHR Micro Diagnostics , Hyderabad, India.

出版信息

Ocul Immunol Inflamm. 2020 Jul 3;28(5):772-774. doi: 10.1080/09273948.2019.1625414. Epub 2019 Aug 20.

Abstract

To report a case of fungal necrotising scleritis following pars plana vitrectomy. : A 65-year-old lady underwent phacoemlsificication with posterior capsular rupture and posteriorly dislocated lens in her left eye. On the same day she underwent 20 gauge pars plana vitrectomy and phacofragmentation. Postoperative period was uneventful for up to 6 weeks when she developed necrotising anterior scleritis with suppurative nodules. Scraping from the suppuration confirmed the presence of Aspergillus flavus. She was treated with topical Voriconazole and oral Itraconazole. : We describe the first case of fungal necrotising scleritis without intraocular inflammation following pars plana vitrectomy (PubMed Search). Infection should be kept in the differential diagnosis of post-operative necrotising scleritis even in the absence of risk factors like hypopyon or diabetes. Early recognition improves final outcome. Medical therapy should be continued even after presumed cure to take care of residual fungi and prevent recurrences.

摘要

报告一例真菌性坏死性巩膜炎继发于玻璃体切除术。:一位 65 岁的女士左眼行白内障超声乳化吸出术伴后囊膜破裂和晶状体后脱位。同日,行 20G 经睫状体平坦部玻璃体切除术和晶状体碎核术。术后 6 周内情况良好,无任何并发症,之后出现化脓性结节坏死性前巩膜炎。从脓性分泌物中刮取物证实为黄曲霉菌。给予局部伏立康唑和口服伊曲康唑治疗。:我们描述了首例玻璃体切除术后(PubMed 检索)无眼内炎症的真菌性坏死性巩膜炎。即使没有低眼压或糖尿病等危险因素,术后坏死性巩膜炎也应考虑感染的鉴别诊断。早期识别可改善最终结果。即使疑似治愈后,也应继续药物治疗以清除残留真菌并预防复发。

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