Billings Beau, Fletcher Drew B, Weaver Alex C, Alkaelani Mohammad Tahseen, Fallgatter Kyle, Daneshvar Ramen
Department of Ophthalmology, University of Florida College of Medicine, 1600 SW Archer Rd, Gainesville, FL, 32608, USA.
University of Florida College of Medicine, 100243, Gainesville, FL, 32610-0243, USA.
Am J Ophthalmol Case Rep. 2023 Jul 9;32:101893. doi: 10.1016/j.ajoc.2023.101893. eCollection 2023 Dec.
This case report highlights scleral perforation as a complication of diode laser transscleral cyclophotocoagulation in the treatment of refractory primary open-angle glaucoma, as well as the management of this complication.
A 78-year-old woman with primary open-angle glaucoma refractory to medication had transscleral cyclophotocoagulation performed in her left eye. During the procedure, it was noted that conjunctival burns and scleral perforation had occurred, at which point the procedure was aborted. Limited peritomy and patch graft with split-thickness donor cornea was done in the area of the scleral thinning and perforation. The patient had a good outcome with an intraocular pressure of 8 mm Hg, appropriate integration of the patch graft, and no significant conjunctival inflammation at the 2-month post-operative visit.
This patient, without any known risk factors for scleral thinning or necrosis, experienced conjunctival burn as well as scleral perforation during transscleral cyclophotocoagulation, underscoring this possible complication of the procedure. Additionally, split-thickness donor cornea was used to patch graft the area of scleral thinning and perforation, which is a method of managing this complication that had not been previously reported.
本病例报告强调了二极管激光经巩膜睫状体光凝术治疗难治性原发性开角型青光眼时巩膜穿孔这一并发症，以及该并发症的处理方法。
一名78岁患有药物难治性原发性开角型青光眼的女性患者接受了左眼经巩膜睫状体光凝术。术中发现发生了结膜烧伤和巩膜穿孔，此时手术中止。在巩膜变薄和穿孔区域进行了有限的结膜切开术和用供体角膜的分层移植片修补。术后2个月随访时，患者眼压为8 mmHg，移植片整合良好，结膜无明显炎症，预后良好。
该患者无任何已知的巩膜变薄或坏死风险因素，在经巩膜睫状体光凝术中发生了结膜烧伤和巩膜穿孔，突出了该手术可能出现的这一并发症。此外，使用供体角膜的分层移植片修补巩膜变薄和穿孔区域，这是一种此前未报道过的处理该并发症的方法。
