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戈尔缝线相关眼内炎,巩膜缝线固定型人工晶状体。

GORE-TEX SUTURE-ASSOCIATED ENDOPHTHALMITIS IN A SCLERAL-SUTURED INTRAOCULAR LENS.

机构信息

Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota.

出版信息

Retin Cases Brief Rep. 2024 May 1;18(3):293-295. doi: 10.1097/ICB.0000000000001400.

Abstract

PURPOSE

To describe a unique case of Gore-Tex (Gore Medical, AZ) suture-associated delayed-onset endophthalmitis in a patient with a history of scleromalacia, pathologic myopia, multiple prior vitrectomies in the setting of a scleral-sutured intraocular lens (IOL).

METHODS

A 69-year-old man complained of blurry vision and eye pain 21 months after implantation of a scleral-sutured IOL and was found to have an exposed Gore-Tex suture with scleromalacia, vision loss to hand motion, a hypopyon, and vitritis. He was diagnosed with culture-positive endophthalmitis. He had a previous history of a rhegmatogenous retinal detachment repair and subsequent dislocated IOL in this eye treated with a scleral-sutured IOL. A vitreous tap and injection of broad-spectrum antibiotics and suture removal at the slit lamp were performed at the time of presentation. One week later, he underwent pars plana vitrectomy and removal of the IOL.

RESULTS

After the tap and inject and subsequent lens removal, his vision has returned to his preoperative vision of 20/100 with refraction.

DISCUSSION

Gore-Tex suture is a nonabsorbable and flexible option with great tensile strength that has emerged as a favored alternative to polypropylene for the use in transscleral fixated IOLs. Although endophthalmitis and suture erosion are known complications of this procedure, this report describes one of the first cases of Gore-Tex suture-associated endophthalmitis.

摘要

目的

描述一例独特的戈尔(戈尔医疗,亚利桑那州)缝线相关迟发性眼内炎病例,患者有巩膜软化症病史、病理性近视、多例既往玻璃体切除术史,伴有巩膜缝线固定的人工晶状体(IOL)。

方法

一名 69 岁男性在植入巩膜缝线固定的 IOL 后 21 个月出现视力模糊和眼痛,被发现有戈尔泰克斯缝线外露,伴有巩膜软化症、视力丧失至手动、前房积脓和眼内炎。他被诊断为培养阳性眼内炎。他之前在这只眼接受过孔源性视网膜脱离修复术和随后的脱位 IOL 治疗,采用巩膜缝线固定的 IOL。在就诊时进行了玻璃体抽取和广谱抗生素注射,并在裂隙灯下取出缝线。一周后,他接受了经睫状体平坦部玻璃体切除术和 IOL 取出术。

结果

在抽取和注射以及随后的晶状体取出后,他的视力恢复到术前的 20/100 屈光状态。

讨论

戈尔泰克斯缝线是一种非吸收性和柔韧性的缝线,具有很强的拉伸强度,已成为经巩膜固定的 IOL 中替代聚丙烯缝线的首选。尽管眼内炎和缝线侵蚀是该手术的已知并发症,但本报告描述了首例戈尔泰克斯缝线相关眼内炎病例之一。

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