Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Cornea. 2020 Jan;39(1):129-131. doi: 10.1097/ICO.0000000000002158.
To report an unusual case of epithelial ingrowth after phacoemulsification with posterior chamber intraocular lens implantation in a patient with recurrent pterygium, along with confocal microscopy findings of epithelial ingrowth.
This is a case report and review of the literature.
A healthy 68-year-old woman presented with epithelial ingrowth with a best-corrected visual acuity of 6/60 in the left eye (-4.0 × 85 DC). She underwent pterygium surgery a decade ago, followed by recurrence 7 years later and an uneventful phacoemulsification surgery with posterior chamber intraocular lens implantation in the previous year. Confocal microscopy showed vacuolated cells in the area of epithelial ingrowth, which were similar to conjunctival cells of the pterygium. The postoperative period after cataract surgery was uneventful.
This is the first case report to document epithelial ingrowth after phacoemulsification in a patient with recurrent pterygium and that demonstrates confocal microscopy findings showing conjunctival cells of pterygium as the origin of epithelial ingrowth. We recommend making clear corneal side-port incisions during phacoemulsification away from the site of pterygium in such cases and to check for postoperative wound leaks and tissue incarceration.
报告 1 例复发性翼状胬肉患者行超声乳化白内障吸除术联合后房型人工晶状体植入术后发生上皮内植入的罕见病例,并结合上皮内植入的共焦显微镜检查结果进行分析。
这是 1 例病例报告,并对相关文献进行了回顾。
1 名 68 岁健康女性左眼因上皮内植入导致最佳矫正视力为 6/60(-4.0×85 DC)而就诊。她在 10 年前接受了翼状胬肉手术,7 年后复发,前 1 年无并发症地接受了超声乳化白内障吸除术联合后房型人工晶状体植入术。共焦显微镜检查显示上皮内植入区有空泡化细胞,与翼状胬肉的结膜细胞相似。白内障手术后的恢复过程顺利。
这是首例报道复发性翼状胬肉患者行超声乳化白内障吸除术后发生上皮内植入的病例,并通过共焦显微镜检查结果证实了翼状胬肉的结膜细胞是上皮内植入的来源。我们建议在这种情况下,行超声乳化白内障吸除术时在远离翼状胬肉部位的角膜侧做透明角膜侧切口,并检查术后伤口渗漏和组织嵌顿情况。