Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, Delhi, India
BMJ Case Rep. 2024 May 27;17(5):e252123. doi: 10.1136/bcr-2022-252123.
A female in her 20s presented with a diminution of vision in the right eye (RE) following an open globe injury (scleral penetration) and repair a year back. At the presentation, she had low intraocular pressure (IOP) of 7 mm Hg, posterior subcapsular cataract (PSC), retrolental vitreous bands incarcerated at the penetration site, disc oedema, tortuous vessels and choroidal folds. Inferotemporal and superonasal cyclodialysis clefts were detected on CASIA 2 optical coherence tomography (OCT). The diagnosis of RE repaired scleral penetration, PSC and cyclodialysis cleft with hypotony maculopathy was made. The case was managed by phacoemulsification with an intraocular lens in the bag and a capsular tension ring in the sulcus, as a tamponading agent to close the cleft. Intraoperatively on endoscopic visualisation, vitreous membrane was noticed encasing the ciliary processes causing a tractional cyclodialysis and hence single port 23G pars plana vitrectomy was performed to relieve the traction. Postsurgery, IOP was 14 mm Hg, and the repaired cleft was visualised on anterior segment OCT.
一位 20 多岁的女性，一年前因开放性眼球损伤（巩膜穿透伤）和修复后出现右眼视力下降。就诊时，右眼眼压为 7mmHg，存在后囊下白内障、在穿透部位嵌顿的眼后玻璃体带、盘水肿、血管扭曲和脉络膜皱褶。在 CASIA 2 光学相干断层扫描（OCT）上检测到颞下和鼻上睫状体分离裂。诊断为右眼巩膜穿透修复、后囊下白内障和睫状体分离裂伴低眼压性黄斑病变。该病例采用白内障超声乳化吸除术联合囊袋内人工晶状体和巩膜下囊袋张力环作为填塞剂以关闭裂孔。术中在内窥镜下观察到玻璃体膜包裹睫状突，引起牵拉性睫状体分离，因此行单通道 23G 经睫状体平坦部玻璃体切除术以缓解牵引。术后眼压为 14mmHg，在前节 OCT 上观察到修复后的裂孔。
