Stainer G A, Binder P S
Ophthalmic Surg. 1981 Aug;12(8):567-70.
A 55-year-old white female underwent a 7.5 mm penetrating keratoplasty for stromal scarring secondary to herpex simplex keratitis. Postoperatively, stromal vascularization and a prolonged graft rejection forced premature suture removal and a prolonged course of topical and systemic glucocorticoids. A mild anterior wound gape spontaneously closed with reduction of steroid therapy. Eighteen months after the original surgery, the patient underwent a relaxing corneal incision to correct 12 diopters of corneal astigmatism. During an inferior incision a small microperforation was noted and the procedure was terminated. Eleven days after the relaxing incision, the patient returned with a "vitreous wick" syndrome through the superior incision. The wound dehiscence and vitreous wick were repaired without incident and the astigmatism was reduced to 7 diopters. Incisions more than 3/4 depth in aphakic patients, or in patients who have required intense steroid therapy should be monitored closely for several days after surgery for microperforations or a wound dehiscence which may lead to a "vitreous wick" syndrome.
一名55岁的白人女性因单纯疱疹性角膜炎继发基质瘢痕接受了7.5毫米穿透性角膜移植术。术后，基质血管化和长期的移植排斥反应迫使提前拆除缝线，并长期使用局部和全身糖皮质激素治疗。随着类固醇治疗的减少，轻度的前部伤口裂开自行闭合。在初次手术18个月后，患者接受了松解性角膜切口以矫正12屈光度的角膜散光。在下方切口时发现一个小的微穿孔，手术终止。松解性切口11天后，患者因通过上方切口出现“玻璃体条索”综合征而复诊。伤口裂开和玻璃体条索得以顺利修复，散光度数降至7屈光度。对于无晶状体患者或需要大量类固醇治疗的患者，深度超过3/4的切口在术后应密切监测数天，以防出现可能导致“玻璃体条索”综合征的微穿孔或伤口裂开。
