PDF(Pubmed)
Abstract：
We reported a case of simultaneous vitrectomy and sclerokeratoplasty (SKP) performed for keratoglobus with extensive corneal rupture and intraocular hemorrhage caused by trauma. A 73-year-old woman was treated for keratoglobus and glaucoma. She was punched in both eyes, her right eye showed corneal rupture and the left eye showed prolapse of the ocular contents due to eyeball rupture. She immediately underwent corneal sutures in the right eye and resection of the prolapsed ocular contents in the left eye at a nearby ophthalmological clinic. Three days after the injury, the patient was referred to our clinic for vision recovery. The best corrected visual acuity of the right eye was measured by counting fingers. Her right eye presented severe corneal edema with a sutured corneal wound in the upper periphery, which was positive in the Seidel test. B-mode ultrasound revealed choroidal detachment and subchoroidal hemorrhage. Fourteen days after injury, simultaneous corneal suture and posterior sclerotomy were performed in the right eye, but corneal fragility and corneal opacity were prominent, and B-mode examination revealed prolonged vitreous hemorrhage and retinal detachment. Twenty-one days after injury, we performed simultaneous SKP and 25-G pars plana vitrectomy (PPV). In this procedure, we initially performed SKP followed by 25-G PPV without a keratoprosthesis or endoscope. The visibility of the fundus through the corneoscleral graft was good during vitrectomy. Three months after surgery, her corrected visual acuity improved to 10/1,000. Although there was mild corneal stromal edema and khodadoust line, there were no obvious fundus complications. Simultaneous SKP and PPV for keratoglobus with extensive corneal rupture and vitreous diseases may be a good option.
摘要：
我们报道了一例同时进行玻璃体切除术和巩膜角膜移植术（SKP）的病例，用于角膜角球伴广泛的角膜破裂和外伤引起的眼内出血。一名73岁的妇女接受了角膜角膜炎和青光眼的治疗。她的双眼都被打了一拳,她的右眼显示角膜破裂，左眼显示眼球破裂引起的眼球内容物脱垂。她立即在附近的眼科诊所进行了右眼角膜缝合，并切除了左眼脱垂的眼内容物。受伤三天后，患者被转介到我们的诊所进行视力恢复。通过计数手指来测量右眼的最佳矫正视力。她的右眼出现严重的角膜水肿，上周边有缝合角膜伤口，在Seidel测试中呈阳性.B超提示脉络膜脱离及脉络膜下出血。受伤后14天，在右眼同时进行角膜缝合和后巩膜切开术，但是角膜脆性和角膜混浊突出，B型检查显示玻璃体出血和视网膜脱离时间延长。受伤后21天,我们同时进行了SKP和25-G平面玻璃体切除术(PPV).在这个过程中，我们最初进行了SKP,然后在没有人工角膜或内窥镜的情况下进行了25-GPPV.在玻璃体切除术期间，通过角膜巩膜移植物的眼底可见性良好。手术三个月后,她的矫正视力提高到10/1,000。尽管有轻度角膜基质水肿和khodadoust线，无明显眼底并发症。同时使用SKP和PPV治疗角膜角球伴广泛的角膜破裂和玻璃体疾病可能是一个不错的选择。
