Rosen C E
Ophthalmic Associates, Anchorage, Alaska 99501, USA.
Ophthalmic Plast Reconstr Surg. 1996 Dec;12(4):260-2; discussion 263. doi: 10.1097/00002341-199612000-00007.
A 31-year-old woman complained of sudden diplopia and proptosis associated with a headache. Approximately 10 years earlier, she had sustained a right orbital blowout fracture during a snow machine accident that was repaired using a Supramid implant. She presented with 4 mm of right-sided proptosis by Hertel exophthalmometry, with limitation of up and down gaze. She manifested a right gaze preference with a left head turn to achieve fusion. Visual acuity was 20/20 on both sides; however, there was 20% red desaturation and a subtle afferent pupillary defect on the right side. Goldmann visual fields were full and the retinal examination was normal. A computed tomography (CT) scan of the orbits with and without contrast demonstrated a large right posterior inferior orbital mass. Once the periorbita was breached during orbitotomy, a burgundy serosanguinous material emerged. Gram staining revealed red cells without organisms. The implant had not been fixed by wires or screws. Upon removal, the implant appeared oversized, encompassing the orbital floor, medial and lateral walls. Postoperatively, the proptosis, gaze preference with face turn, afferent pupillary defect, desaturation abnormality, and diplopia resolved.
一名31岁女性主诉突发复视、眼球突出并伴有头痛。大约10年前，她在雪地摩托事故中右眼发生眼眶爆裂性骨折，当时使用Supramid植入物进行了修复。通过Hertel眼球突出计测量，她右眼眼球突出4毫米，向上和向下注视受限。她表现出右眼注视偏好，需向左转头以实现双眼融合。双眼视力均为20/20；然而，右侧有20%的红色饱和度降低以及轻微的传入性瞳孔障碍。Goldmann视野检查正常，视网膜检查也正常。眼眶计算机断层扫描（CT）平扫及增强扫描显示右侧眼眶后下象限有一个巨大肿块。眼眶切开术中切开眶骨膜后，流出一种紫红色的浆液性血性物质。革兰氏染色显示有红细胞但无微生物。植入物未用金属丝或螺钉固定。取出时，植入物显得过大，覆盖了眶底、内侧壁和外侧壁。术后，眼球突出、面部转动引起的注视偏好、传入性瞳孔障碍、饱和度异常和复视均消失。
