Phthisis Bulbi in a Retinitis Pigmentosa Patient after Argus II Implantation.

IF 0.7 Q4 OPHTHALMOLOGY
Case Reports in Ophthalmological Medicine Pub Date : 2020-08-17 eCollection Date: 2020-01-01 DOI:10.1155/2020/5608058
Logan Vander Woude, Ramak Roohipour, Gibran Syed Khurshid
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Abstract

Purpose: To report a previously unreported complication of phthisis after Argus II prosthesis implantation in a retinitis pigmentosa (RP) patient.

Case: A 61-year-old male with advanced RP presented to the retina clinic. The patient had a history of vitrectomy in both eyes (OU) in Cuba in 1996. Pre-op visual acuity (VA) was no light perception (NLP) in the right eye and light perception (LP) in the left eye. The patient met the criteria for Argus II implantation and elected to proceed with surgery in his left eye in December 2017. The surgical implantation of the Argus II was successful without any complications. On postoperative day 1, his VA was stable at LP. He was satisfied with his ambulatory vision after the electrodes were turned on. Four months after surgery, the patient was complaining of aching pain; he was found to have preseptal cellulitis and was started on antibiotics. This swelling improved over two weeks, but when the patient returned, he had a two mm hyphema associated with mild ocular inflammation without an inciting event or reason on exam. The hyphema was treated and resolved after two weeks. However, one month after the hyphema resolved, at postoperative month six, the patient's vision in his left eye became NLP and began to demonstrate phthisical changes, including hypotony, Descemet membrane folds, and a vascular posterior capsular membrane. Discussion. The theoretical causes of phthisis bulbi after Argus II implantation include fibrous downgrowth, ciliary shut down due to immune reaction, inflammation, or trauma. While the cause of phthisis in this Argus patient is not certain and possibly multifactorial, it is important to note that phthisis is a possible complication of an Argus II implant, as this patient had no other obvious insult or reason for the phthisical change.

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阿格斯II型视网膜植入术后视网膜色素变性患者的球芽炎。
目的:报道一例视网膜色素变性(RP)患者Argus II假体植入术后的肺结核并发症。病例:一名61岁男性晚期RP提交视网膜诊所。患者曾于1996年在古巴进行双眼玻璃体切除术。术前视力(VA)为右眼无光感(NLP),左眼无光感(LP)。该患者符合Argus II植入标准,并于2017年12月选择进行左眼手术。Argus II的手术植入是成功的,没有任何并发症。术后第1天,VA稳定在LP。电极打开后,他对自己的移动视力感到满意。术后4个月,患者主诉疼痛;他被发现患有隔膜蜂窝织炎,并开始使用抗生素。这种肿胀在两周后有所改善,但当患者返回时,检查时发现2毫米前房积血并伴有轻度眼部炎症,没有任何刺激事件或原因。前房积血得到治疗,两周后消退。然而,在前房积血消退1个月后,即术后第6个月,患者左眼视力变为NLP,并开始表现出实质改变,包括低斜视、Descemet膜皱褶和血管后囊膜。讨论。Argus II型植入术后球型肺结核的理论原因包括纤维下降、免疫反应、炎症或创伤引起的纤毛关闭。虽然本例Argus患者的肺结核病因尚不确定,可能是多因素的,但值得注意的是,肺结核可能是Argus II型植入物的并发症,因为该患者没有其他明显的损伤或原因导致肺结核改变。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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