PDF(Pubmed)
Abstract：
OBJECTIVE: To report two cases of hypotony with maculopathy related to cyclodialysis cleft after Yamane intraocular lens (IOL) implantation, and the use of localized transscleral cyclophotocoagulation (TSCPC) to successfully treat this condition.
METHODS: 1. 37 year-old man with childhood BB-gun related injury in the left eye (OS) and traumatic iridodialysis and angle recession underwent pars plana vitrectomy and Yamane IOL placement for subluxed traumatic cataract OS. Postoperative hypotony [intraocular pressure (IOP) 5-6 mmHg] and maculopathy with best corrected vision acuity (BCVA) of 20/200 at 1 month postoperative prompted referral, and localized TSCPC was performed. Nine days later sudden elevation of IOP occurred, responsive to treatment, and the hypotony and maculopathy resolved. 2. 87 year-old man with prior OS retinal detachments treated with scleral buckling, pars plana vitrectomy x 2, and cataract extraction with sulcus IOL ranging from 8 to 37 years prior presented with temporal sulcus IOL haptic penetration through the iris and dense vitreous hemorrhage. He underwent pars plana vitrectomy, IOL explantation and Yamane IOL placement OS. Postoperative hypotony (IOP 1-4 mmHg) and maculopathy with evidence of cyclodialysis cleft on ultrasonography at 1 month postoperative prompted referral. The patient underwent 2 rounds of localized TSCPC; after his second treatment, IOP ranged from 9 to 14 mmHg over the next 8 months and maculopathy resolved.
CONCLUSIONS: We highlight the risk of development of cyclodialysis cleft after Yamane IOL placement in highly traumatized eyes, and the benefit of localized TSCPC in such cases for cleft closure.
METHODS: 1. 37 year-old man with childhood BB-gun related injury in the left eye (OS) and traumatic iridodialysis and angle recession underwent pars plana vitrectomy and Yamane IOL placement for subluxed traumatic cataract OS. Postoperative hypotony [intraocular pressure (IOP) 5-6 mmHg] and maculopathy with best corrected vision acuity (BCVA) of 20/200 at 1 month postoperative prompted referral, and localized TSCPC was performed. Nine days later sudden elevation of IOP occurred, responsive to treatment, and the hypotony and maculopathy resolved. 2. 87 year-old man with prior OS retinal detachments treated with scleral buckling, pars plana vitrectomy x 2, and cataract extraction with sulcus IOL ranging from 8 to 37 years prior presented with temporal sulcus IOL haptic penetration through the iris and dense vitreous hemorrhage. He underwent pars plana vitrectomy, IOL explantation and Yamane IOL placement OS. Postoperative hypotony (IOP 1-4 mmHg) and maculopathy with evidence of cyclodialysis cleft on ultrasonography at 1 month postoperative prompted referral. The patient underwent 2 rounds of localized TSCPC; after his second treatment, IOP ranged from 9 to 14 mmHg over the next 8 months and maculopathy resolved.
CONCLUSIONS: We highlight the risk of development of cyclodialysis cleft after Yamane IOL placement in highly traumatized eyes, and the benefit of localized TSCPC in such cases for cleft closure.
摘要：
目的：报道2例山药人工晶状体（IOL）植入术后眼压低下合并黄斑病变的病例。并使用局部经巩膜睫状体光凝（TSCPC）成功治疗这种疾病。
方法：1.37岁的男性患有儿童BB枪相关的左眼（OS）损伤，并患有创伤性虹膜透析和角度凹陷，接受了平坦部玻璃体切除术和YamaneIOL放置治疗半脱位性外伤性白内障OS。术后低眼压[眼压（IOP）5-6mmHg]和黄斑病变，术后1个月最佳矫正视力（BCVA）为20/200，提示转诊，并进行局部TSCPC。9天后眼压突然升高，对治疗有反应，低眼压和黄斑病变解决了.2.87岁男性，既往有OS视网膜脱离，接受巩膜扣带术治疗，平坦部玻璃体切除术x2，白内障摘除术后8至37年，出现颞侧沟IOL触觉穿透虹膜和致密玻璃体出血。他接受了平坦部玻璃体切除术，IOL外植体和YamaneIOL放置OS。术后低眼压（IOP1-4mmHg）和黄斑病变，术后1个月超声检查提示转诊。患者接受了2轮局部TSCPC；在他的第二次治疗后，在接下来的8个月中，IOP范围为9至14mmHg，黄斑病变得以缓解。
结论：我们强调了在高度创伤的眼睛中放置YamaneIOL后发生环透析裂的风险，以及在这种情况下局部TSCPC对裂隙闭合的好处。
方法：1.37岁的男性患有儿童BB枪相关的左眼（OS）损伤，并患有创伤性虹膜透析和角度凹陷，接受了平坦部玻璃体切除术和YamaneIOL放置治疗半脱位性外伤性白内障OS。术后低眼压[眼压（IOP）5-6mmHg]和黄斑病变，术后1个月最佳矫正视力（BCVA）为20/200，提示转诊，并进行局部TSCPC。9天后眼压突然升高，对治疗有反应，低眼压和黄斑病变解决了.2.87岁男性，既往有OS视网膜脱离，接受巩膜扣带术治疗，平坦部玻璃体切除术x2，白内障摘除术后8至37年，出现颞侧沟IOL触觉穿透虹膜和致密玻璃体出血。他接受了平坦部玻璃体切除术，IOL外植体和YamaneIOL放置OS。术后低眼压（IOP1-4mmHg）和黄斑病变，术后1个月超声检查提示转诊。患者接受了2轮局部TSCPC；在他的第二次治疗后，在接下来的8个月中，IOP范围为9至14mmHg，黄斑病变得以缓解。
结论：我们强调了在高度创伤的眼睛中放置YamaneIOL后发生环透析裂的风险，以及在这种情况下局部TSCPC对裂隙闭合的好处。
