Brockhurst R J, Ward R C, Lou P, Ormerod D, Albert D
Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts.
Am J Ophthalmol. 1993 Apr 15;115(4):524-9. doi: 10.1016/s0002-9394(14)74457-5.
In six patients, removal of solid silicone scleral buckling implant materials that had been in place between eight and 21 years disclosed gray-white deposits firmly adherent to the silicone. Four of the six patients had culture-proven infections, whereas two had no evidence of infection and had negative cultures. One of these two patients, however, had intermittent pain, which was the indication for removal of the implant. Analysis of the deposits disclosed that they were calcium phosphate. The exact mechanism responsible for the calcification on the silicone material is unknown. Dystrophic calcification can occur without infection in injured tissue wherein extracellular deposits of devitalized cells, blood cells, and lipids may act as a nidus for calcification. In the presence of infection, bacteria may serve as such a nidus. Additionally, it is possible that biofilm produced by the bacteria had a role in the deposition of calcium phosphate, as well as in its firm adhesion to the silicone materials. We considered the possibility of similar deposits developing on intraocular silicone lenses.
在6例患者中,取出已植入8至21年的固体硅胶巩膜扣带植入材料时,发现灰白色沉积物牢固地附着于硅胶上。6例患者中有4例经培养证实存在感染,而另外2例没有感染证据,培养结果为阴性。然而,这2例患者中有1例有间歇性疼痛,这是取出植入物的指征。对沉积物的分析表明它们是磷酸钙。硅胶材料上钙化的确切机制尚不清楚。营养不良性钙化可在无感染的受伤组织中发生,其中失活细胞、血细胞和脂质的细胞外沉积物可能成为钙化的病灶。在有感染的情况下,细菌可能充当这样的病灶。此外,细菌产生的生物膜可能在磷酸钙的沉积以及其与硅胶材料的牢固粘附方面发挥了作用。我们考虑了眼内硅胶晶状体上出现类似沉积物的可能性。