Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, U.S.A.
Department of Oculofacial Plastic and Orbital Surgery, Shiley Eye Institute, University of San Diego California, San Diego, California, U.S.A.
Ophthalmic Plast Reconstr Surg. 2024;40(4):374-379. doi: 10.1097/IOP.0000000000002625. Epub 2024 Feb 19.
This study aims to address the infrequent but serious complication of globe injuries in blepharoplasty.
A case series of 3 patients with globe injuries postblepharoplasty is presented, along with a systematic literature review that revealed 13 previously reported cases. Quantitative and comparative analysis is described.
Injuries ranged from deep thermal burns to full-thickness corneal or scleral lacerations, with one instance of traumatic cataract. The median time from surgery to symptom onset was 1 day, with a concerning median delay of 7 days to presentation to an ophthalmologist. Visual outcomes were generally poor, with nearly all patients experiencing permanent visual morbidity. The systematic review revealed 3 cases of endophthalmitis following perforating scleral injuries. Comparative analysis showed no significant differences in visual outcomes between penetrating and perforating injuries.
The findings of this study emphasize the need for increased vigilance for globe injuries that require prompt ophthalmological evaluation following blepharoplasty, especially considering the observed delay in presentation and the extent of visual morbidity. The study advocates for improved practitioner training in recognizing and managing these complications and underscores the importance of patient education regarding the potential risks and the necessity of timely postoperative care.
本研究旨在探讨眼睑成形术后眼球损伤这一罕见但严重的并发症。
报告了 3 例眼睑成形术后眼球损伤的病例,并进行了系统的文献回顾,共发现 13 例先前报道的病例。对其进行了定量和对比分析。
损伤程度从深度热烧伤到全层角膜或巩膜撕裂不等,有一例创伤性白内障。从手术到症状出现的中位数时间为 1 天,令人担忧的是,到眼科医生就诊的中位数延迟时间为 7 天。视力结果普遍较差,几乎所有患者都存在永久性视力损伤。系统评价显示 3 例穿透性巩膜损伤后发生眼内炎。对比分析显示,穿透性和穿孔性损伤的视力结果无显著差异。
本研究结果强调了需要提高警惕,警惕眼睑成形术后需要立即进行眼科评估的眼球损伤,尤其是考虑到观察到的就诊延迟以及视力损伤的程度。该研究主张加强从业者对这些并发症的识别和管理的培训,并强调对潜在风险和及时术后护理的必要性进行患者教育的重要性。