Ophthalmology Department, Pierre-Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France; and.
Ophthalmology Unit, Clinique Honoré Cave, Montauban, France.
Retin Cases Brief Rep. 2024 Jul 1;18(4):521-525. doi: 10.1097/ICB.0000000000001428. Epub 2023 Oct 9.
The purpose of this study was to describe the surgical management of bilateral giant full-thickness macular hole with sudden onset two months after cataract surgery in a patient with Alport syndrome.
This was an observational, single-case report.
A 54-year-old woman with a history of Alport syndrome presented with severe bilateral visual loss two months after cataract surgery. The diagnosis of bilateral giant full-thickness macular hole was made. We found the absence of the internal limiting membrane and the inability to lift and peel a continuous posterior hyaloid sheet during surgical management with 25-gauge pars plana vitrectomy (left eye). Amniotic membrane grafting followed by gas tamponade were performed for hole closure. The hole remained closed but vision was poorly restored two months after.
Cataract surgery in patients with Alport syndrome could promote early development of giant full-thickness macular hole. Collagen defects could underlie internal limiting membrane absence and the inability to properly peel the posterior hyaloid.
本研究旨在描述一名 Alport 综合征患者在白内障手术后两个月突发双侧巨大全层黄斑裂孔的手术治疗方法。
这是一项观察性、单病例报告。
一名 54 岁女性,有 Alport 综合征病史,在白内障手术后两个月出现严重双侧视力丧失。诊断为双侧巨大全层黄斑裂孔。我们发现,在 25G 经睫状体平坦部玻璃体切除术(左眼)手术治疗中,内界膜缺失,无法提起和剥离连续的后玻璃体膜。行羊膜移植联合气体填充以封闭裂孔。裂孔闭合,但术后两个月视力恢复不佳。
Alport 综合征患者的白内障手术可促使巨大全层黄斑裂孔的早期发生。胶原缺陷可能导致内界膜缺失和后玻璃体膜无法正确剥离。