Gozawa Makoto, Orii Yusuke, Takamura Yoshihiro, Inatani Masaru
Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Japan.
Am J Ophthalmol Case Rep. 2024 Aug 30;36:102163. doi: 10.1016/j.ajoc.2024.102163. eCollection 2024 Dec.
To report a rare case of globe rupture with broken calcified senile scleral plaque (SSP).
A 94-year-old male patient presented with left eye pain and severely decreased left vision immediately after the injury while farming. Examination of the left eye revealed edematous cornea, diffuse subconjunctival hemorrhage, total hyphema and iris prolapse. Preoperative computed tomography (CT) scan revealed calcified SSP in both eyes, and the calcified SSP was found to be broken during surgery. Although it was impossible to thread the broken calcified SSP, threading and suturing with long bites outside of the broken calcified SSP was effective for wound closure. Postoperatively, we were able to observe the broken calcified SSP and the wound closure using anterior segment optical coherence tomography (AS-OCT).
In a case of globe rupture with calcified SSP on preoperative CT, the possibility that the SSP has also ruptured should be considered. AS-OCT is also useful to observe the wound in a case of globe rupture with broken SSP during follow-up.
报告一例罕见的伴有钙化性老年巩膜斑块（SSP）破裂的眼球破裂病例。
一名94岁男性患者在务农时受伤后立即出现左眼疼痛和左眼视力严重下降。左眼检查发现角膜水肿、结膜下弥漫性出血、全前房积血和虹膜脱出。术前计算机断层扫描（CT）显示双眼均有钙化性SSP，术中发现钙化性SSP破裂。尽管无法穿过破裂的钙化性SSP，但在破裂的钙化性SSP外部进行长针脚的穿线和缝合对伤口闭合有效。术后，我们能够使用眼前节光学相干断层扫描（AS-OCT）观察破裂的钙化性SSP和伤口闭合情况。
对于术前CT显示有钙化性SSP的眼球破裂病例，应考虑SSP也已破裂的可能性。在随访过程中，AS-OCT对于观察伴有破裂SSP的眼球破裂病例的伤口也很有用。
