巩膜固定人工晶状体植入术后无晶状体囊袋复合体情况下的迟发性眼内炎：一例报告
Delayed-Onset Endophthalmitis in the Absence of Capsular Complex Following Scleral-Fixated Intraocular Lens: A Case Report.
作者信息
Gonzalez-Gonzalez Luis A, Prensky Colin J, Orlin Anton
机构信息
Department of Ophthalmology, Weill Cornell Medicine, New York, NY, USA.
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
出版信息
J Vitreoretin Dis. 2021 Feb 12;5(5):448-451. doi: 10.1177/2474126421989584. eCollection 2021 Sep-Oct.
PURPOSE
This work reports a case of delayed-onset endophthalmitis in a patient with scleral-fixated intraocular lens (IOL), successfully treated with intravitreal antibiotics and steroids.
METHODS
Patient underwent complete ophthalmic examinations over 2 years. Vitreous cultures, optical coherence tomography, anterior segment and fundus photographs, and fluorescein angiogram were performed.
RESULTS
A 78-year-old man with dislocated IOL underwent IOL removal and scleral-fixated AO60. He did well for 2 months but returned 9 months later with vision loss. Examination revealed low-grade inflammation and multiple IOL opacities. Vitreous culture grew . He was treated with intravitreal clindamycin followed by dexamethasone for macular edema without IOL explantation. A year after treatment no inflammation or macular edema was noted.
CONCLUSION
To our knowledge, this is the first case of endophthalmitis following scleral sutured IOL. Treatment with intravitreal injections alone, without IOL explantation, was effective, possibly because of the absence of capsular complex.
目的
本研究报告了1例巩膜固定人工晶状体（IOL）植入术后迟发性眼内炎患者，经玻璃体腔注射抗生素和类固醇成功治疗。
方法
对患者进行了为期2年的全面眼科检查。进行了玻璃体培养、光学相干断层扫描、眼前节和眼底照相以及荧光素血管造影。
结果
1例78岁人工晶状体脱位男性患者接受了人工晶状体取出术并植入巩膜固定AO60人工晶状体。术后2个月情况良好，但9个月后因视力下降复诊。检查发现低度炎症和多处人工晶状体混浊。玻璃体培养有……生长。患者接受了玻璃体腔注射克林霉素治疗，随后因黄斑水肿注射地塞米松，未取出人工晶状体。治疗1年后未发现炎症或黄斑水肿。
结论
据我们所知，这是首例巩膜缝合人工晶状体术后发生眼内炎的病例。仅通过玻璃体腔注射治疗，未取出人工晶状体，是有效的，可能是因为不存在囊袋复合体。
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