Bechay Joseph, Rosenberg Sedona, Flynn Erin, Bitar Maya
The George Washington University, 2150 Pennsylvania Avenue, Washington, D.C, 20037, United States.
Am J Ophthalmol Case Rep. 2024 Nov 26;36:102223. doi: 10.1016/j.ajoc.2024.102223. eCollection 2024 Dec.
The purpose of this case series is to report three cases of exposed, unburied polytetrafluoroethylene (Gore-tex) sutures used for scleral fixated intraocular lenses and their management, including failure of pericardial patch and success of irradiated corneal patch. This series aims to inform management options for this uncommon adverse event.
A retrospective case series was conducted of three patients who presented at a tertiary care center with exposure of unburied Gore-tex sutures used for fixation of intraocular lens. All three patients underwent initial suture revision with pericardial graft patching. Chart review was conducted to assess past ocular history, operative technique for lens fixation surgery, time from this surgery to suture exposure, time to pericardial patch failure, and long-term outcome.Results showed that pericardial patch grafting failed within several months in all three cases. One patient subsequently had an irradiated corneal graft placed and still had a successful outcome after 36 months of follow-up. Possible risk factors for suture erosion were identified as a surgical history of pterygium excision and loose or unburied suture knots.
Pericardial patch grafting may not work well for unburied Gore-tex suture exposure. Eyes with prior complex histories are at risk for erosion of unburied Gore-tex sutures with surgical repair required.
本病例系列旨在报告3例用于巩膜固定人工晶状体的外露、未埋藏的聚四氟乙烯（戈尔特斯）缝线情况及其处理，包括心包补片失败和辐照角膜补片成功的案例。本系列旨在为这一罕见不良事件的处理提供参考。
对在一家三级医疗中心就诊的3例患者进行回顾性病例系列研究，这些患者因用于固定人工晶状体的未埋藏戈尔特斯缝线外露。所有3例患者均首先进行了心包移植物修补的缝线修复。进行病历审查以评估既往眼部病史、晶状体固定手术的操作技术、从该手术到缝线外露的时间、心包补片失败的时间以及长期预后。结果显示，所有3例心包补片移植均在数月内失败。1例患者随后接受了辐照角膜移植，随访36个月后仍取得成功。缝线侵蚀的可能危险因素被确定为翼状胬肉切除手术史以及缝线结松散或未埋藏。
心包补片移植对于未埋藏的戈尔特斯缝线外露可能效果不佳。有复杂既往病史的眼睛存在未埋藏戈尔特斯缝线侵蚀的风险，需要进行手术修复。
