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巩膜扣带术后伴嗜麦芽窄食单胞菌感染的手术诱发坏死性巩膜炎

Surgically-Induced Necrotizing Scleritis After Scleral Buckling With Stenotrophomonas maltophilia Infection.

作者信息

Nakagawa Yoshihiro, Suzuki Takahiro, Suzuki Yasuyuki

机构信息

Ophthalmology, Tokai University Hospital, Isehara, JPN.

出版信息

Cureus. 2024 Feb 8;16(2):e53876. doi: 10.7759/cureus.53876. eCollection 2024 Feb.

Abstract

Surgically induced necrotizing scleritis (SINS) is a rare inflammatory disease of the sclera that occurs following ocular surgery, specifically pterygium surgery and scleral buckling. Here, we report a case of SINS in a 78-year-old female patient after segmental scleral buckling for rhegmatogenous retinal detachment. The retina was restored after scleral buckling, and the postoperative course was uneventful. However, the patient developed ocular discharge and conjunctival hyperemia, indicating infection, after two months. The sclera became thinner and intraocular inflammation developed after buckle removal. was isolated from the ocular discharge, and the patient was treated with antibacterial agents susceptible to the bacteria. However, her symptoms persisted, and corrected visual acuity decreased from 20/25 to 20/1000. Oral steroid treatment was initiated because of the suspicion of SINS. Intraocular inflammation gradually subsided, the thin sclera was covered by conjunctival tissue, and the patient's corrected visual acuity improved to 20/32, which stabilized her condition. Infection with after scleral buckling is extremely rare, and SINS development in such cases is unprecedented.

摘要

手术性坏死性巩膜炎(SINS)是一种罕见的巩膜炎症性疾病,发生于眼部手术后,特别是翼状胬肉手术和巩膜扣带术后。在此,我们报告一例78岁女性患者在因孔源性视网膜脱离行节段性巩膜扣带术后发生SINS的病例。巩膜扣带术后视网膜复位,术后过程平稳。然而,两个月后患者出现眼部分泌物及结膜充血,提示感染。取出扣带后巩膜变薄,眼内炎症发展。从眼部分泌物中分离出[具体细菌名称未给出],患者接受了对该细菌敏感的抗菌药物治疗。然而,她的症状持续存在,矫正视力从20/25降至20/1000。由于怀疑为SINS,开始口服类固醇治疗。眼内炎症逐渐消退,变薄的巩膜被结膜组织覆盖,患者的矫正视力提高到20/32,病情得以稳定。巩膜扣带术后感染[具体细菌名称未给出]极为罕见,此类病例中发生SINS更是前所未有的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0880/10924889/3ee13fe1857f/cureus-0016-00000053876-i01.jpg

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