PDF(Pubmed)
Abstract：
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly employed perioperatively to reduce intraoperative prostaglandin release, diminishing pain, preventing miosis, modulating postoperative inflammation, and reducing the incidence of cystoid macular edema (CME).
METHODS: A 70-year-old female patient without previous history of ocular or systemic disease was urgently referred to our hospital because of a sudden corneal perforation concerning her left eye (OS). The patient had instilled bromfenac eye drops and antiseptic eye drops twice and four times daily, respectively, for 2 days only, in preparation of scheduled cataract surgery. Slit-lamp examination revealed diffuse inferior corneal melting with a 1 × 2 mm area of full-thickness perforation and a very shallow anterior chamber. Both topical agents were immediately discontinued. Cyanoacrylate glue was applied to seal the perforation and a bandage contact lens was applied together with a topical antibiotic given hourly. Two hours later, the anterior chamber started to reform. The following day, the anterior chamber was fully reformed with a negative Seidel test. At her next follow-up appointment, 1 month later, the glue was detached and the cornea was seen to have successfully healed with only some corneal thinning remaining inferiorly.
CONCLUSIONS: Perioperative use of topical NSAIDs in combination with antiseptic eye drops may rarely elicit corneal perforation in certain susceptible elderly individuals. Their use should therefore be carefully monitored.
METHODS: A 70-year-old female patient without previous history of ocular or systemic disease was urgently referred to our hospital because of a sudden corneal perforation concerning her left eye (OS). The patient had instilled bromfenac eye drops and antiseptic eye drops twice and four times daily, respectively, for 2 days only, in preparation of scheduled cataract surgery. Slit-lamp examination revealed diffuse inferior corneal melting with a 1 × 2 mm area of full-thickness perforation and a very shallow anterior chamber. Both topical agents were immediately discontinued. Cyanoacrylate glue was applied to seal the perforation and a bandage contact lens was applied together with a topical antibiotic given hourly. Two hours later, the anterior chamber started to reform. The following day, the anterior chamber was fully reformed with a negative Seidel test. At her next follow-up appointment, 1 month later, the glue was detached and the cornea was seen to have successfully healed with only some corneal thinning remaining inferiorly.
CONCLUSIONS: Perioperative use of topical NSAIDs in combination with antiseptic eye drops may rarely elicit corneal perforation in certain susceptible elderly individuals. Their use should therefore be carefully monitored.
摘要：
背景：非甾体抗炎药（NSAIDs）通常用于围手术期，以减少术中前列腺素的释放，减轻疼痛，预防瞳孔缩小，调节术后炎症，并降低黄斑囊样水肿（CME）的发生率。
方法：一名70岁女性患者，既往无眼部或全身性疾病史，因左眼（OS）突然发生角膜穿孔，紧急转诊至我院。患者每天两次和四次滴注溴芬酸滴眼液和防腐剂滴眼液，分别,只有2天,准备预定的白内障手术。裂隙灯检查显示弥漫性下角膜融化，全层穿孔面积为1×2mm，前房非常浅。两种局部用药立即停止。施用氰基丙烯酸酯胶以密封穿孔,并将绷带接触镜与每小时给予的局部抗生素一起施用。两小时后,前房开始改革。第二天,在Seidel试验阴性的情况下，前房完全重建。在她的下一次随访中，一个月后,胶水脱落，角膜成功愈合，只有一些角膜变薄。
结论：围手术期局部使用NSAIDs联合抗菌滴眼液在某些易感老年人中很少引起角膜穿孔。因此，应仔细监测其使用情况。
方法：一名70岁女性患者，既往无眼部或全身性疾病史，因左眼（OS）突然发生角膜穿孔，紧急转诊至我院。患者每天两次和四次滴注溴芬酸滴眼液和防腐剂滴眼液，分别,只有2天,准备预定的白内障手术。裂隙灯检查显示弥漫性下角膜融化，全层穿孔面积为1×2mm，前房非常浅。两种局部用药立即停止。施用氰基丙烯酸酯胶以密封穿孔,并将绷带接触镜与每小时给予的局部抗生素一起施用。两小时后,前房开始改革。第二天,在Seidel试验阴性的情况下，前房完全重建。在她的下一次随访中，一个月后,胶水脱落，角膜成功愈合，只有一些角膜变薄。
结论：围手术期局部使用NSAIDs联合抗菌滴眼液在某些易感老年人中很少引起角膜穿孔。因此，应仔细监测其使用情况。
