PDF(Pubmed)
Abstract：
BACKGROUND: We report a case of eye-penetrating injury in which a massive silicone oil migration into the patient\'s subconjunctival space and orbit occurred after vitrectomy.
METHODS: A 30-year-old male patient sought medical attention at Ganzhou People\'s Hospital after experiencing pain and vision loss in his left eye due to a nail wound on December 9, 2023. Diagnosis of penetrating injury caused by magnetic foreign body retention in the left eye and hospitalization for treatment. On December 9, 2023, pars plana vitrectomy was performed on the left eye for intraocular foreign body removal, abnormal crystal extraction, retinal photocoagulation. Owing to the discovery of retinal detachment at the posterior pole during surgery, silicone oil was injected to fill the vitreous body, following which upper conjunctival bubble-like swelling was observed. Postoperative orbital computed tomography (CT) review indicated migration of silicone oil to the subconjunctival space and orbit through a self-permeable outlet. On December 18, 2023, the patient sought treatment at the First Affiliated Hospital of Nanchang University, China. The patient presented with a pronounced foreign body sensation following left eye surgery. On December 20, 2023, the foreign body was removed from the left eye frame and an intraocular examination was conducted. The posterior scleral tear had closed, leading to termination of the surgical procedure following supplementary laser treatment around the tear. The patient reported a significant reduction in ocular surface symptoms just one day after surgery. Furthermore, a notable decrease in the migration of silicone oil was observed in orbital CT scans.
CONCLUSIONS: The timing of silicone oil injection for an eye-penetrating injury should be carefully evaluated to avoid the possibility of silicone oil migration.
METHODS: A 30-year-old male patient sought medical attention at Ganzhou People\'s Hospital after experiencing pain and vision loss in his left eye due to a nail wound on December 9, 2023. Diagnosis of penetrating injury caused by magnetic foreign body retention in the left eye and hospitalization for treatment. On December 9, 2023, pars plana vitrectomy was performed on the left eye for intraocular foreign body removal, abnormal crystal extraction, retinal photocoagulation. Owing to the discovery of retinal detachment at the posterior pole during surgery, silicone oil was injected to fill the vitreous body, following which upper conjunctival bubble-like swelling was observed. Postoperative orbital computed tomography (CT) review indicated migration of silicone oil to the subconjunctival space and orbit through a self-permeable outlet. On December 18, 2023, the patient sought treatment at the First Affiliated Hospital of Nanchang University, China. The patient presented with a pronounced foreign body sensation following left eye surgery. On December 20, 2023, the foreign body was removed from the left eye frame and an intraocular examination was conducted. The posterior scleral tear had closed, leading to termination of the surgical procedure following supplementary laser treatment around the tear. The patient reported a significant reduction in ocular surface symptoms just one day after surgery. Furthermore, a notable decrease in the migration of silicone oil was observed in orbital CT scans.
CONCLUSIONS: The timing of silicone oil injection for an eye-penetrating injury should be carefully evaluated to avoid the possibility of silicone oil migration.
摘要：
背景：我们报告了一例眼穿透性损伤，其中玻璃体切除术后硅油大量迁移到患者的结膜下间隙和眼眶。
方法：2023年12月9日，一名30岁男性患者因指甲伤导致左眼疼痛和视力下降，到赣州市人民医院就诊。左眼磁性异物滞留所致穿透性损伤的诊断及住院治疗。2023年12月9日，对左眼进行了平坦部玻璃体切除术，以去除眼内异物，异常晶体提取，视网膜光凝.由于在手术过程中发现了后极的视网膜脱离，注入硅油填充玻璃体，随后观察到上结膜泡状肿胀。术后眼眶计算机断层扫描（CT）检查显示硅油通过自渗透出口迁移到结膜下空间和眼眶。2023年12月18日，患者在南昌大学第一附属医院寻求治疗，中国。左眼手术后患者出现明显的异物感。2023年12月20日，将异物从左眼架中取出，并进行眼内检查。后巩膜撕裂已经闭合，导致在撕裂周围进行补充激光治疗后终止外科手术。患者在手术后仅一天报告眼表症状显著减轻。此外，在眼眶CT扫描中观察到硅油的迁移显著减少.
结论：应仔细评估眼部穿透伤的硅油注射时机，以避免硅油迁移的可能性。
方法：2023年12月9日，一名30岁男性患者因指甲伤导致左眼疼痛和视力下降，到赣州市人民医院就诊。左眼磁性异物滞留所致穿透性损伤的诊断及住院治疗。2023年12月9日，对左眼进行了平坦部玻璃体切除术，以去除眼内异物，异常晶体提取，视网膜光凝.由于在手术过程中发现了后极的视网膜脱离，注入硅油填充玻璃体，随后观察到上结膜泡状肿胀。术后眼眶计算机断层扫描（CT）检查显示硅油通过自渗透出口迁移到结膜下空间和眼眶。2023年12月18日，患者在南昌大学第一附属医院寻求治疗，中国。左眼手术后患者出现明显的异物感。2023年12月20日，将异物从左眼架中取出，并进行眼内检查。后巩膜撕裂已经闭合，导致在撕裂周围进行补充激光治疗后终止外科手术。患者在手术后仅一天报告眼表症状显著减轻。此外，在眼眶CT扫描中观察到硅油的迁移显著减少.
结论：应仔细评估眼部穿透伤的硅油注射时机，以避免硅油迁移的可能性。
