Watanabe D, Fujie J, Kawano S, Kubota N
Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.
Nippon Ganka Gakkai Zasshi. 1997 Jun;101(6):520-4.
We report four cases with late infection following a scleral buckling procedure. These cases were a 44-year-old male, a 52-year-old female, a 59-year-old male, and a 60-year-old male. All of these cases developed conjunctival injection, chemosis, and mucopurulent discharge 7 to 15 years after the procedure. The symptoms did not improve despite months of medical therapy, suggesting scleral buckle infection, and finally the buckling materials were removed. Solid silicone was used in 2 cases, and a sponge was used in 2 cases, with encircling elements in 1 case, and without encircling elements in 3 cases. Pus culture of the removal exoplant revealed fungaul infection in 2 cases. The others were negative, but bacterial infection was suspected from their clinical course and intraoperative findings. After removal of the buckles, the symptoms improved rapidly in all cases and there was no recurrence of retinal detachment. Scleral buckle infection should be suspected and removal of buckling materials should be considered, in cases with refractory conjunctival and scleral inflammation even years after scleral buckling procedure.
我们报告了4例巩膜扣带术后迟发性感染的病例。这些病例分别为一名44岁男性、一名52岁女性、一名59岁男性和一名60岁男性。所有这些病例在手术7至15年后均出现结膜充血、水肿和黏液脓性分泌物。尽管经过数月的药物治疗,症状仍未改善,提示巩膜扣带感染,最终移除了扣带材料。2例使用了固体硅胶,2例使用了海绵,1例有环扎元件,3例没有环扎元件。移除的植入物脓性培养显示2例为真菌感染。其他培养结果为阴性,但从临床病程和术中发现怀疑有细菌感染。移除扣带后,所有病例症状迅速改善,视网膜脱离未复发。对于巩膜扣带术后数年出现难治性结膜和巩膜炎症的病例,应怀疑巩膜扣带感染并考虑移除扣带材料。