Maretz Caroline, Green Kyle M, Wozniak Rachel A F
Department of Ophthalmology, Flaum Eye Institute, University of Rochester Medical Center, USA.
Am J Ophthalmol Case Rep. 2022 Apr 29;26:101561. doi: 10.1016/j.ajoc.2022.101561. eCollection 2022 Jun.
PVC is a synthetic plastic polymer used worldwide for a wide range of applications. While it is often associated with ocular trauma, little is known regarding how PVC may interact with ocular tissues. Herein we report the clinical course of a patient with polyvinyl chloride (PVC) embedded in the cornea after a projectile injury, utilizing anterior segment optical tomography to study the relative antigenicity and reactivity of this industrial material in the cornea.
A 29-year-old male presented with acute, unilateral vision loss in the left eye following ocular trauma while working with PVC. On exam, he had a near full-thickness corneal laceration with multiple small fragments of PVC in the corneal stroma. Given the small size and depth of the fragments, the patient was medically managed with close follow-up. After 6 days, his visual acuity returned to baseline and the corneal laceration was found to be well healed. Anterior OCT imaging identified discrete, individual fragments and there was no associated inflammatory response. At 3 months, the patient continued to do well with no signs of ocular inflammation.
PVC is a commonly used plastic in workplace settings that pose a risk for projectile injuries to the eye. This case highlights that at least in the short-term, PVC appears to be inert in the corneal stroma, allowing for medical management and close follow-up, rather than surgical removal.
聚氯乙烯(PVC)是一种在全球范围内广泛应用于各种领域的合成塑料聚合物。虽然它常与眼外伤相关,但关于PVC如何与眼组织相互作用却知之甚少。在此,我们报告了一名因投射物损伤导致角膜嵌入聚氯乙烯(PVC)的患者的临床病程,利用眼前节光学断层扫描技术研究这种工业材料在角膜中的相对抗原性和反应性。
一名29岁男性在从事PVC工作时眼部受伤后,出现左眼急性单侧视力丧失。检查发现,他有近乎全层的角膜裂伤,角膜基质中有多个小的PVC碎片。鉴于碎片尺寸小且深度浅,对该患者进行了药物治疗并密切随访。6天后,他的视力恢复到基线水平,角膜裂伤愈合良好。眼前节光学相干断层扫描(OCT)成像显示有离散的单个碎片,且无相关炎症反应。3个月时,患者情况持续良好,无眼部炎症迹象。
PVC是工作场所常用的塑料,存在眼部投射物损伤风险。该病例表明,至少在短期内,PVC在角膜基质中似乎是惰性的,可采用药物治疗和密切随访,而非手术取出。