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新型冠状病毒肺炎感染所致可植入式胶原晶状体植入术后迟发性葡萄膜炎:一例报告

Delayed uveitis after implantable Collamer lens Implantation caused by COVID-19 infection: a case report.

作者信息

Sun Yan, Wu Huiying, Yan Xingke, Zhou Jibo, Niu Tianyue, Zhu Jie

机构信息

Department of Refractive Surgery, Lanzhou Bright Eye Hospital Lanzhou 730030, Gansu, China.

Department of Refractive Surgery, Nanchang Bright Eye Hospital Nanchang 330038, Jiangxi, China.

出版信息

Am J Transl Res. 2025 May 15;17(5):3565-3570. doi: 10.62347/HHLS1617. eCollection 2025.

DOI:10.62347/HHLS1617
PMID:40535667
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12170392/
Abstract

This report presents a case of uveitis secondary to ankylosing spondylitis (AS) with abnormal exudative deposits and pigment adhesion on the surface of an implantable Collamer lens (ICL) in a highly myopic eye following coronavirus disease 2019 (COVID-19) infection. The etiology and treatment were analyzed. A 22-year-old male presented with decreased visual acuity in the right eye, having undergone bilateral ICL implantation for high myopia 22 months prior. During the COVID-19 pandemic, he developed ocular exudation, pigment deposition, and vision deterioration, with a confirmed diagnosis of AS. Therapeutic interventions included anti-inflammatory, antiviral, and corticosteroid therapies. Postoperative uveitis secondary to AS following ICL implantation represents a rare complication. COVID-19 infection and concurrent systemic autoimmune disorders were identified as risk factors for secondary iridocyclitis. Immunological testing confirmed AS diagnosis. Treatment with sodium hyaluronate eye drops, ganciclovir ophthalmic gel, and systemic corticosteroids improved symptoms; however, persistent punctate exudates and pigment deposits on the ICL surface exhibited limited resolution. For patients with systemic autoimmune diseases or virus-induced uveitis undergoing ICL implantation, preoperative immunological screening should be actively performed to minimize postoperative complications. Early comprehensive therapy is critical to prevent progressive vision loss and rare transparency alterations of the ICL surface caused by pigment-laden exudates.

摘要

本报告介绍了一例2019冠状病毒病(COVID-19)感染后高度近视眼中,继发于强直性脊柱炎(AS)的葡萄膜炎病例,该病例中可植入式可折叠人工晶状体(ICL)表面出现异常渗出性沉积物和色素附着。对其病因及治疗进行了分析。一名22岁男性,右眼视力下降,22个月前因高度近视接受了双眼ICL植入术。在COVID-19大流行期间,他出现眼部渗出、色素沉着和视力恶化,确诊为AS。治疗干预措施包括抗炎、抗病毒和皮质类固醇治疗。ICL植入术后继发于AS的葡萄膜炎是一种罕见的并发症。COVID-19感染和并发的全身性自身免疫性疾病被确定为继发性虹膜睫状体炎的危险因素。免疫学检测确诊为AS。使用透明质酸钠滴眼液、更昔洛韦眼用凝胶和全身性皮质类固醇治疗改善了症状;然而,ICL表面持续存在的点状渗出物和色素沉着仅得到有限程度的缓解。对于患有全身性自身免疫性疾病或病毒诱导性葡萄膜炎且接受ICL植入术的患者,应积极进行术前免疫学筛查,以尽量减少术后并发症。早期综合治疗对于预防视力渐进性丧失以及由含色素渗出物引起的ICL表面罕见的透明度改变至关重要。

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本文引用的文献

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J Refract Surg. 2025 Mar;41(3):e199-e206. doi: 10.3928/1081597X-20250123-01. Epub 2025 Mar 1.
2
Characterization of spike S1/S2 processing and entry pathways of lentiviral pseudoviruses bearing seasonal human coronaviruses NL63, 229E, and HKU1 spikes.携带季节性人类冠状病毒NL63、229E和HKU1刺突的慢病毒假病毒刺突S1/S2加工及进入途径的表征
Microbiol Spectr. 2025 Mar 4;13(3):e0280824. doi: 10.1128/spectrum.02808-24. Epub 2025 Jan 28.
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Characteristics of ocular findings of patients with coronavirus disease 2019 in China.中国2019冠状病毒病患者眼部表现特征
Front Med (Lausanne). 2025 Jan 13;11:1292821. doi: 10.3389/fmed.2024.1292821. eCollection 2024.
4
Analysis of the correlations between changes in posterior segment and anterior chamber segment after implantable collamer lens implantation in highly myopic patients.高度近视患者植入可植入式角膜胶原晶状体后眼后段与眼前段变化的相关性分析
BMC Ophthalmol. 2025 Jan 21;25(1):33. doi: 10.1186/s12886-025-03863-w.
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Pharmacological Accommodative Changes of Haptic Position and Its Impact on Vault After ICL Implantation.
J Refract Surg. 2025 Jan;41(1):e22-e28. doi: 10.3928/1081597X-20241126-02. Epub 2025 Jan 1.
6
Anterior and Posterior Ocular Changes in Patients with Active and Inactive Ankylosing Spondylitis.活动期和非活动期强直性脊柱炎患者的眼前部和后部眼部变化
Med Sci Monit. 2025 Jan 9;31:e946834. doi: 10.12659/MSM.946834.
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Heliyon. 2024 Oct 31;10(22):e39791. doi: 10.1016/j.heliyon.2024.e39791. eCollection 2024 Nov 30.
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