Kalantan Hatem, Albuainain Abdulrahman, Otaif Wael, Alfawaz Abdullah M, Abusayf Mohammed M, AlBloushi Abdulrahman F
Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Eye and Laser Center, Bahrain Defence Force Hospital, Royal Medical Services, Military Hospital, Riffa, Bahrain.
BMC Ophthalmol. 2025 Apr 1;25(1):160. doi: 10.1186/s12886-025-03926-y.
To report a case of scleral melting following implantation of a Gore-Tex-sutured scleral-fixated intraocular lens (SFIOL).
Single-case report.
A 39-year-old man with a history of blunt trauma and crystalline lens subluxation presented with a 3-week history of left-eye pain, redness, and foreign-body sensation. He had undergone pars plana vitrectomy, and SFIOL using silk sutures one-year earlier; however, the intraocular lens (IOL) was unstable and was replaced with a Gore-Tex suture. On presentation, his best-corrected visual acuity was counting fingers near the face in the left eye. The left eye had episcleral and conjunctival injection, clear cornea, a deep anterior chamber with occasional cellular reaction, a peaked pupil inferonasally, and temporal subluxation of the IOL. A large area of active temporal scleral melt with prolapsed uveal tissue and an exposed Gore-Tex suture knot were noted. Systemic work-up was unremarkable. Oral prednisolone and methotrexate were initiated, and a scleral patch graft was performed to cover the exposed suture and enhance the structural integrity of the scleral wall. However, the scleral melt continued to involve the nasal side, and the patient underwent another scleral patch grafting over the nasal side. Rituximab was also administered, but the scleral melt persisted. Therefore, the Gore-Tex suture and IOL were removed. Five months later, the patient remained stable without further melting.
Although Gore-Tex suture-related complications are rare, further long-term studies are warranted. The early detection and treatment of suture-related complications can optimize visual outcomes and prevent devastating sequelae.
报告一例使用戈尔特斯（Gore-Tex）缝线固定的巩膜固定人工晶状体（SFIOL）植入术后巩膜溶解的病例。
单病例报告。
一名39岁男性，有钝挫伤和晶状体半脱位病史，出现左眼疼痛、发红和异物感3周。他一年前接受了玻璃体切除术和平坦部巩膜固定人工晶状体植入术，使用的是丝线缝线；然而，人工晶状体不稳定，随后更换为戈尔特斯缝线。就诊时，他左眼的最佳矫正视力为眼前数指。左眼有巩膜和结膜充血，角膜透明，前房深，偶尔有细胞反应，瞳孔向鼻下移位，人工晶状体颞侧半脱位。可见颞侧大片活动性巩膜溶解，伴有葡萄膜组织脱垂和暴露的戈尔特斯缝线结。全身检查无异常。开始口服泼尼松龙和甲氨蝶呤，并进行巩膜补片移植以覆盖暴露的缝线并增强巩膜壁的结构完整性。然而，巩膜溶解继续累及鼻侧，患者又在鼻侧进行了一次巩膜补片移植。还给予了利妥昔单抗，但巩膜溶解仍持续存在。因此，移除了戈尔特斯缝线和人工晶状体。五个月后，患者病情稳定，未再出现巩膜溶解。
尽管与戈尔特斯缝线相关的并发症很少见，但仍需要进一步的长期研究。早期发现和治疗与缝线相关的并发症可以优化视觉效果并预防严重的后遗症。
