Corbelli Eleonora, Fantaguzzi Federico, Iuliano Lorenzo, Knutsson Karl Anders, Bandello Francesco
School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.
Division of Head and Neck, Ophthalmology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Am J Ophthalmol Case Rep. 2024 Aug 22;36:102150. doi: 10.1016/j.ajoc.2024.102150. eCollection 2024 Dec.
To report a challenging case of corneal descemetocele following Nd:YAG laser capsulotomy for posterior capsule opacification in a patient with Steven Johnson syndrome (SJS).
A single-eye 52 year-old man, with a history of Steven Johnson syndrome, presented with severe eye pain and profound vision reduction in his left eye two days after undergoing Nd:YAG laser capsulotomy using the standard Abraham contact lens. A corneal descemetocele was identified and subsequently confirmed by anterior segment optical coherence tomography. He was promptly treated with the application of a therapeutic contact lens and sustained antibiotic regimen (preservative-free fluoroquinolone drops every 4 hours for 6 weeks) until healing of the corneal epithelium. Throughout the following eight weeks AS-OCT showed favorable anatomical and functional outcomes, achieving a substantial spontaneous healing.
Corneal descemetocele may occur after Nd:YAG laser capsulotomy in patients with Steven Johnson syndrome. This case strengthens the critical importance of a careful preoperative assessment and meticulous postoperative management in high-risk patients, such as those with Steven Johnson syndrome, even after seemingly routine and safe ophthalmic procedures.
报告1例史蒂文斯-约翰逊综合征（SJS）患者在进行Nd:YAG激光后囊切开术治疗后囊膜混浊后发生角膜后弹力层膨出的具有挑战性的病例。
一名52岁单眼男性，有史蒂文斯-约翰逊综合征病史，在使用标准亚伯拉罕接触镜进行Nd:YAG激光后囊切开术两天后，左眼出现严重眼痛和视力大幅下降。发现角膜后弹力层膨出，随后经眼前节光学相干断层扫描证实。立即给他佩戴治疗性接触镜并持续使用抗生素方案（每4小时滴注不含防腐剂的氟喹诺酮滴眼液，持续6周），直至角膜上皮愈合。在接下来的八周内，眼前节光学相干断层扫描显示出良好的解剖和功能结果，实现了显著的自发愈合。
史蒂文斯-约翰逊综合征患者在Nd:YAG激光后囊切开术后可能发生角膜后弹力层膨出。该病例强化了对高危患者（如史蒂文斯-约翰逊综合征患者）进行仔细的术前评估和精心的术后管理的至关重要性，即使是在看似常规且安全的眼科手术后。
