Massengill Michael, Blake Charles Richard
University of Florida College of Medicine, Gainesville, Florida, USA.
Department of Ophthalmology, University of Florida, Gainesville, Florida, USA.
Case Rep Ophthalmol. 2020 Jul 3;11(2):263-267. doi: 10.1159/000508604. eCollection 2020 May-Aug.
We report the self-limited nature of corneal opacification after accidental injection of Healon5 into the corneal stroma. A 52-year-old male with a new diagnosis of severe stage, primary open-angle glaucoma underwent successful trabeculectomy OS, which was complicated by ocular hypotony and shallow anterior chamber (AC) on postoperative day 1. Healon5, a hyaluronic acid-containing viscoelastic device, was accidentally introduced into the corneal stroma during attempted injection into the AC. The cornea hydrodissected and opacified, leading to precipitous loss of best-corrected visual acuity (BCVA). The corneal opacification spontaneously resolved over a 7-month period without specific intervention. During this period, the patient also underwent cataract extraction with posterior chamber intraocular lens placement and YAG capsulotomy, after which his BCVA returned to approximately baseline. Though intrastromal injection of sodium hyaluronate-containing material has been reported elsewhere, this complication with Healon5 use specifically has yet to be described in the literature and may occur in any procedure involving Healon5 in the AC. This case report is important, since the precipitous loss of BCVA can be alarming to the ophthalmologist and the patient. The affected patient may be counseled that the opacification should improve with time.
我们报告了意外将Healon5注入角膜基质后角膜混浊的自限性。一名新诊断为重度原发性开角型青光眼的52岁男性成功接受了左眼小梁切除术，术后第1天出现低眼压和浅前房并发症。Healon5是一种含透明质酸的粘弹剂，在试图注入前房时意外注入角膜基质。角膜发生水分离并混浊，导致最佳矫正视力（BCVA）急剧下降。角膜混浊在7个月内自行消退，无需特殊干预。在此期间，患者还接受了白内障摘除联合后房型人工晶状体植入术和YAG囊切开术，术后其BCVA恢复至大致基线水平。虽然其他地方曾报道过含透明质酸钠材料的基质内注射，但Healon5使用的这种并发症在文献中尚未描述，且可能发生在任何涉及前房使用Healon5的手术中。本病例报告很重要，因为BCVA的急剧下降可能会让眼科医生和患者感到担忧。对于受影响的患者，可以告知其混浊会随时间改善。
