Department of Ophthalmology, Stanford University, Byers Eye Institute, Palo Alto, California.
Department of Ophthalmology, Palo Alto Medical Foundation, Palo Alto, California.
J AAPOS. 2023 Aug;27(4):233-236. doi: 10.1016/j.jaapos.2023.05.004. Epub 2023 Jun 23.
Well-known risk factors for anterior segment ischemia (ASI) following strabismus surgery include ipsilateral surgery on three or more rectus muscles, older age, and vasculopathy. ASI is rarely reported in young patients following uneventful strabismus surgery on two ipsilateral rectus muscles. We report a 30-year-old transgender female on long-term estrogen therapy who underwent strabismus surgery involving recessions of both lateral rectus muscles, the right inferior rectus muscle, and the left superior rectus muscle. The left eye developed severe ASI with hypotony maculopathy that was resistant to topical medications, oral steroids, anterior chamber reformation, and intravitreal steroid injection. Following phacoemulsification with intraocular lens and capsular tension ring insertion 1 year later, intraocular pressure and hypotony maculopathy improved.
已知斜视手术后前段缺血（ASI）的风险因素包括同侧三条或以上直肌手术、年龄较大和血管病变。在对两条同侧直肌进行无并发症斜视手术后，年轻患者很少发生 ASI。我们报告了一名 30 岁的跨性别女性，她长期接受雌激素治疗，接受了双侧外直肌、右眼下直肌和左眼上直肌后退的斜视手术。左眼发生严重的 ASI，伴有低眼压性黄斑病变，对局部药物、口服类固醇、前房重建和玻璃体内类固醇注射均有抵抗。1 年后行白内障超声乳化联合人工晶状体和囊袋张力环植入术后，眼压和低眼压性黄斑病变得到改善。
