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患者曾行眼睑放射治疗,且患有未确诊的类风湿性关节炎,在一次无并发症的白内障手术后一周发生急性角膜融解:病例报告。

Acute corneal melting one week after an uncomplicated cataract surgery in a patient who previously underwent eyelid radiation and with undiagnosed rheumatoid arthritis: a case report.

机构信息

Department of Ophthalmology, General Hospital of Trikala, Greece.

Department of Ophthalmology, AHEPA University Hospital, Thessaloniki, Greece.

出版信息

Arq Bras Oftalmol. 2021 Jan-Feb;84(1):87-90. doi: 10.5935/0004-2749.20210025.

Abstract

This is a rare case report of acute, paracentral corneal melting and perforation occurring 1 week after an uneventful cataract surgery, with discussions on possible pathogenetic mechanisms. Relevant literature was also reviewed. Herein, a case of an 86-year-old woman with acute, paracentral, and sterile corneal melting and perforation in her left eye at 1 week after an uncomplicated cataract extraction is described. This occurs at the base of ocular surface disorders due to previous radiation of her lower eyelid and cheeks for the treatment of cancer and previously undiagnosed rheumatoid arthritis. She underwent surgical treatment using Gundersen's conjunctival flap for the existing perforation due to low visual expectancies and reluctance to undergo corneal keratoplasty due to the risk of corneal graft rejection. The risk of coming across an acute corneal melting after an uncomplicated cataract surgery in the eyes with ocular surface disorders should always be considered.

摘要

这是一例罕见的病例报告,描述了一位 86 岁女性在无并发症白内障手术后 1 周出现急性、旁中心性角膜融解和穿孔。讨论了可能的发病机制,并回顾了相关文献。该患者左眼在无并发症白内障手术后 1 周出现急性、旁中心性、无菌性角膜融解和穿孔,这是由于下眼睑和脸颊因癌症接受先前的放射治疗以及先前未确诊的类风湿性关节炎引起的眼表面疾病的基础上发生的。由于低视力预期和对角膜移植排斥的风险导致不愿进行角膜角膜移植,因此对现有穿孔采用冈德森氏结膜瓣进行了手术治疗。在眼表面疾病的眼中,即使是在无并发症的白内障手术后,也应始终考虑到急性角膜融解的风险。

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