Psilas K, Papadimitriou C S
J Fr Ophtalmol. 1984;7(2):133-5.
A 75 year woman with chronic vitreous hemorrhage underwent extraction of a senile cataract. Surgery was complicated by the flow of brown fluid from the vitreous to the anterior chamber, which was not entirely removed. Post-operatively there was pain, 2 mm of brown hypopyon and intraocular pressure elevation to 60 mm Hg with the preoperative diagnosis of endophthalmitis, a pars plana vitreous tap and instillation of intravitreal antibiotics was performed. Bacterial cultures were negative and the presence of erythrocyte "ghost cells" established the diagnosis of hemolytic glaucoma. As medical management proved ineffective, a pars plana vitrectomy was performed. One year post-operatively the patient had a visual acuity of 0.4-0.5, normal intraocular pressure without medication and evidence of an old branch retinal vein occlusion. The mechanism of hemolytic "ghost-cell" glaucoma in this case is discussed.
一位患有慢性玻璃体出血的75岁女性接受了老年性白内障摘除术。手术出现并发症,棕色液体从玻璃体流入前房,且未完全清除。术后出现疼痛、2毫米棕色前房积脓,眼压升高至60毫米汞柱,术前诊断为眼内炎,遂行睫状体平坦部玻璃体穿刺并注入玻璃体内抗生素。细菌培养结果为阴性,红细胞“幽灵细胞”的存在确诊为溶血性青光眼。由于药物治疗无效,遂进行了睫状体平坦部玻璃体切除术。术后一年,患者视力为0.4 - 0.5,眼压在未用药情况下正常,有陈旧性视网膜分支静脉阻塞的迹象。本文讨论了该病例中溶血性“幽灵细胞”青光眼的发病机制。