An Unusual Case of an Open Globe due to Airbag Injury and Scleral Lens Use

Mary K. Wilson, Lee P. Bowman, Jonathan K. Hu, Charles R. Blake
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Abstract

A 30-year-old woman who wears scleral contact lenses for keratoconus was brought to the emergency room after a motor vehicle collision where a deployed airbag hit her left eye. The patient was taken to the operating room for globe exploration and found to have two large scleral lacerations (one superiorly and one temporally) with significant uveal prolapse. After primary repair, she developed a retinal detachment with proliferative vitreoretinopathy, vitreous hemorrhage and a full hyphema. She underwent a vitrectomy, retinal detachment repair and penetrating keratoplasty corneal transplant. We believe the extent of her trauma is due to a unique mechanism of injury in which the scleral lens acted like a punch, creating two scleral lacerations, and expulsing the ciliary body. To our knowledge, this is the first report of scleral lens induced open globe trauma.
因气囊损伤和使用巩膜透镜导致开球体的罕见病例
一名因角膜炎而佩戴巩膜接触镜的 30 岁女性在一次车祸中被展开的安全气囊击中左眼,随后被送到急诊室。患者被送入手术室进行眼球探查,发现有两处大的巩膜裂伤(一处在上部,一处在颞部),并伴有严重的葡萄膜脱垂。初级修复术后,她出现了视网膜脱离,伴有增殖性玻璃体视网膜病变、玻璃体出血和全眼底下出血。她接受了玻璃体切除术、视网膜脱离修复术和穿透性角膜移植术。我们认为,她的创伤程度是由一种独特的损伤机制造成的,巩膜透镜就像一记重拳,造成了两处巩膜裂伤,并将睫状体排出体外。据我们所知,这是第一例巩膜透镜引起的开球创伤报告。
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