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钝性眼外伤后后囊膜破裂导致的渐进性远视屈光改变。

Progressive hyperopic refractive changes after posterior capsule tear following blunt ocular trauma.

作者信息

Shibata Teppei, Seki Yusuke, Seida Yukiya, Yoshita Tsuyoshi, Tsuchiya Shunsuke, Sasaki Hiroshi, Kubo Eri

机构信息

Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan.

Yoshita Eye Clinic, Ishikawa, Japan.

出版信息

Am J Ophthalmol Case Rep. 2024 Mar 1;34:102032. doi: 10.1016/j.ajoc.2024.102032. eCollection 2024 Jun.

Abstract

PURPOSE

To describe the mechanism of progressive hyperopia and its management in the long-term course of traumatic cataract with a posterior capsule tear (PCT) following blunt ocular trauma.

OBSERVATION

A 37-year-old woman presented with blurry vision and photophobia after being hit in the right eye by a slipper. She was found to have PCT with the formation of a traumatic cataract with emmetropia (0 diopters [D]). Three years after the injury, a broader hyperopic change of +8.0 D was found in the patient at her first visit to our clinic. Optical coherence tomography (OCT) analysis of the anterior segment of the eye revealed damage to the posterior capsule and cataracts due to disorganization of the lens fibers and liquefaction of the lens. Femtosecond laser-associated cataract surgery was performed for anterior capsulotomy and segmentation of the nucleus without further enlargement of the PCT, facilitating the placement of a capsular tension ring segment and a multifocal intra ocular lens (IOL) in the capsular bag. At 1-month post-operation, her uncorrected visual acuity was 20/20 in the right eye, with a well-centered IOL.

CONCLUSIONS AND IMPORTANCE

Isolated PCT due to blunt trauma is rare, and there have been no reports of progressive hyperopia after three years of follow-up. In such cases, the lens may liquefy, resulting in decreased refraction and significant hyperopia.

摘要

目的

描述钝性眼外伤后伴有后囊膜破裂(PCT)的外伤性白内障长期病程中渐进性远视的机制及其处理。

观察

一名37岁女性在右眼被拖鞋击中后出现视力模糊和畏光症状。检查发现其存在后囊膜破裂并伴有形成了屈光正常(0屈光度[D])的外伤性白内障。受伤三年后,该患者首次到我院就诊时发现有+8.0 D的更明显远视变化。眼部前段光学相干断层扫描(OCT)分析显示,后囊膜受损,晶状体纤维紊乱和晶状体液化导致白内障形成。进行了飞秒激光辅助白内障手术,行前囊切开和晶状体核分割,未进一步扩大后囊膜破裂口,便于在囊袋内植入囊袋张力环片段和多焦点人工晶状体(IOL)。术后1个月,其右眼裸眼视力为20/20,人工晶状体居中良好。

结论与意义

钝性外伤导致的孤立性后囊膜破裂很少见,且尚无三年随访后出现渐进性远视的报道。在此类病例中,晶状体可能会液化,导致屈光力下降和显著远视。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cd6/10921238/437d4ebcd835/gr1.jpg

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