Osipyan G A, Zaitsev A V, Budnikova E A, Marchenko N R, Meliksetyan N A
Krasnov Research Institute of Eye Diseases, Moscow, Russia.
Vestn Oftalmol. 2024;140(4):74-79. doi: 10.17116/oftalma202414004174.
The problem of treating purulent scleral infections, rare but extremely severe complication of ophthalmic surgeries, remains unresolved. This article presents a case of successful surgical treatment of purulent scleritis - interlamellar scleral abscess - that developed in a patient after repeat penetrating keratoplasty performed due to infectious lysis of the transplant. Although the first keratoplasty was performed for acanthamoeba keratitis, there were no signs of acanthamoeba invasion in the transplant at the time of the second surgery. Scleritis manifested as an infiltrate with pus penetrating the anterior chamber and development of keratoiridocyclitis. During surgery, the abscess cavity was opened, irrigated with an antiseptic solution, and drained into the subconjunctival space; the anterior chamber was irrigated with balanced salt solution through a separate paracentesis. No infection recurrences were noted in the postoperative period and the corneal transplant remained clear.
治疗化脓性巩膜感染(眼科手术罕见但极其严重的并发症)的问题仍未得到解决。本文介绍了一例成功手术治疗化脓性巩膜炎——板层间巩膜脓肿的病例,该病例发生在一名因移植感染溶解而接受重复穿透性角膜移植术后的患者身上。尽管首次角膜移植是针对棘阿米巴角膜炎进行的,但在第二次手术时,移植片中没有棘阿米巴侵袭的迹象。巩膜炎表现为伴有脓液的浸润,穿透前房并发展为角膜虹膜睫状体炎。手术过程中,脓肿腔被打开,用消毒液冲洗,并引流到结膜下间隙;通过单独的前房穿刺用平衡盐溶液冲洗前房。术后未发现感染复发,角膜移植保持清晰。