PDF(Pubmed)
Abstract：
UNASSIGNED: To report the clinical course of an aphakic patient who developed positional secondary angle closure glaucoma following pars plana vitrectomy (PPV) with perfluoropropane (C3F8) gas tamponade.
UNASSIGNED: A 23-year-old male presented due to a two-year history of vision loss in the left eye. Best-corrected visual acuity (BCVA) was 20/200 and intraocular pressure (IOP) was 12 mm Hg OS. Exam revealed iridodonesis and aphakia of both eyes, and a total RRD in the left eye. The patient underwent scleral buckle plus PPV with 15 % C3F8 gas and was instructed to maintain face-down positioning for 5 days. On post-operative day 1, IOP was 32 mm Hg and exam revealed significant diffuse corneal edema, a large epithelial defect, and 85 % C3F8 fill of the vitreous cavity. Patient was started on IOP-lowering drops but continued to have elevated IOP and corneal epithelial sloughing over the next 3 weeks. He was taken for a superficial keratectomy, but when placed supine under the microscope, a large new gas bubble was visualized overlying the pupil in a now shallow anterior chamber (AC) and IOP was 52 mm Hg. The patient was positioned back upright and the gas bubble migrated posteriorly out of the AC with return of IOP to 25 mm Hg. The dynamic nature of his IOP raised concerns for intermittent angle closure by C3F8 induced by supine positioning. Thus, a pars plana aspiration of the C3F8 gas was performed and resulted in normalization of the IOP.
UNASSIGNED: Dynamic, positional secondary angle closure glaucoma can occur after vitrectomy with C3F8 in the setting of aphakia. This is the first report to capture C3F8 gas migration causing intermittent acute angle closure in real-time. Due to its intermittent nature however, the diagnosis may not be initially apparent at the slit lamp. Thus, we suggest this potential complication should be carefully monitored for and discussed when advising post-vitrectomy positioning in aphakic patients.
UNASSIGNED: A 23-year-old male presented due to a two-year history of vision loss in the left eye. Best-corrected visual acuity (BCVA) was 20/200 and intraocular pressure (IOP) was 12 mm Hg OS. Exam revealed iridodonesis and aphakia of both eyes, and a total RRD in the left eye. The patient underwent scleral buckle plus PPV with 15 % C3F8 gas and was instructed to maintain face-down positioning for 5 days. On post-operative day 1, IOP was 32 mm Hg and exam revealed significant diffuse corneal edema, a large epithelial defect, and 85 % C3F8 fill of the vitreous cavity. Patient was started on IOP-lowering drops but continued to have elevated IOP and corneal epithelial sloughing over the next 3 weeks. He was taken for a superficial keratectomy, but when placed supine under the microscope, a large new gas bubble was visualized overlying the pupil in a now shallow anterior chamber (AC) and IOP was 52 mm Hg. The patient was positioned back upright and the gas bubble migrated posteriorly out of the AC with return of IOP to 25 mm Hg. The dynamic nature of his IOP raised concerns for intermittent angle closure by C3F8 induced by supine positioning. Thus, a pars plana aspiration of the C3F8 gas was performed and resulted in normalization of the IOP.
UNASSIGNED: Dynamic, positional secondary angle closure glaucoma can occur after vitrectomy with C3F8 in the setting of aphakia. This is the first report to capture C3F8 gas migration causing intermittent acute angle closure in real-time. Due to its intermittent nature however, the diagnosis may not be initially apparent at the slit lamp. Thus, we suggest this potential complication should be carefully monitored for and discussed when advising post-vitrectomy positioning in aphakic patients.
摘要：
■报告无晶状体患者的临床过程，该患者在使用全氟丙烷（C3F8）气体填塞的平坦部玻璃体切除术（PPV）后发展为位置继发性闭角型青光眼。
■一名23岁的男性因左眼有两年的视力丧失史而出现。最佳矫正视力（BCVA）为20/200，眼内压（IOP）为12mmHgOS。检查显示双眼虹膜和无晶状体，和左眼的总RRD。患者接受巩膜扣加含15％C3F8气体的PPV，并被指示保持面朝下定位5天。术后第1天，眼压为32mmHg，检查显示明显的弥漫性角膜水肿，一个大的上皮缺损,和85%的C3F8填充玻璃体腔。患者开始使用降低IOP的滴剂,但在接下来的3周内继续具有升高的IOP和角膜上皮脱落。他被带去做了角膜浅层切除术,但是当放在显微镜下仰卧时，在现在的浅前房（AC）中，可以看到一个大的新气泡覆盖瞳孔，眼压为52mmHg。患者直立放置，气泡向后移出AC，眼压恢复到25mmHg。他的IOP的动态特性引起了人们对仰卧位引起的C3F8间歇性闭角的担忧。因此，对C3F8气体进行平坦部抽吸,并导致IOP正常化.
■动态，在无晶状体眼的情况下，C3F8玻璃体切除术后可发生位置性继发性闭角型青光眼。这是第一份实时捕获C3F8气体迁移导致间歇性锐角闭合的报告。然而，由于其间歇性，在裂隙灯的诊断最初可能并不明显。因此，我们建议在建议无晶状体患者进行玻璃体切除术后定位时,应仔细监测和讨论这种潜在的并发症.
■一名23岁的男性因左眼有两年的视力丧失史而出现。最佳矫正视力（BCVA）为20/200，眼内压（IOP）为12mmHgOS。检查显示双眼虹膜和无晶状体，和左眼的总RRD。患者接受巩膜扣加含15％C3F8气体的PPV，并被指示保持面朝下定位5天。术后第1天，眼压为32mmHg，检查显示明显的弥漫性角膜水肿，一个大的上皮缺损,和85%的C3F8填充玻璃体腔。患者开始使用降低IOP的滴剂,但在接下来的3周内继续具有升高的IOP和角膜上皮脱落。他被带去做了角膜浅层切除术,但是当放在显微镜下仰卧时，在现在的浅前房（AC）中，可以看到一个大的新气泡覆盖瞳孔，眼压为52mmHg。患者直立放置，气泡向后移出AC，眼压恢复到25mmHg。他的IOP的动态特性引起了人们对仰卧位引起的C3F8间歇性闭角的担忧。因此，对C3F8气体进行平坦部抽吸,并导致IOP正常化.
■动态，在无晶状体眼的情况下，C3F8玻璃体切除术后可发生位置性继发性闭角型青光眼。这是第一份实时捕获C3F8气体迁移导致间歇性锐角闭合的报告。然而，由于其间歇性，在裂隙灯的诊断最初可能并不明显。因此，我们建议在建议无晶状体患者进行玻璃体切除术后定位时,应仔细监测和讨论这种潜在的并发症.
