高压清洗机导致的非穿孔性眼部挫伤患者的角膜移植手术:病例报告

Mana Miyata, Takashi Ono, Y. Mori, Toshihiro Sakisaka, R. Nejima, Takuya Iwasaki, Takashi Miyai, Kazunori Miyata
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引用次数: 0

摘要

本报告详细介绍了一例罕见的高压清洗机损伤病例,该病例导致眼挫伤、玻璃体出血和不可逆转的角膜水肿,但没有穿孔,因此必须进行角膜移植手术。 我们对宫田眼科医院(日本宫崎县)一名高压清洗机损伤患者的病历进行了回顾性研究。 一名 57 岁的男子在就诊前一天因高压清洗机造成左眼挫伤而到我院就诊。左眼视力为手部运动。左眼裂隙灯检查发现角膜上皮缺损、结膜裂伤、红斑和虹膜裂伤。前房观察到晶状体轻度混浊,提示白内障。前段光学相干断层扫描显示前房有血丝,角膜增厚水肿。超声波检查显示存在玻璃体出血。因此,在全身麻醉下进行了玻璃体手术和外伤性白内障摘除术。术后,角膜水肿和明显混浊持续存在,并伴有青光眼,视力为 0.01。伤后 1 年 2 个月进行了穿透性角膜移植术,伤后 2 年在局部麻醉下进行了眼内晶状体巩膜固定术。受伤 3.5 年后,在佩戴硬性透气接触镜的情况下,最终视力为 0.1,患者需要服用抗青光眼药物。 我们的患者因高压清洗机造成眼外伤。虽然没有发现眼裂,但需要进行角膜移植手术。必须提供足够的重型机械使用说明,以营造安全的工作环境。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Corneal Transplantation in a Patient With Nonperforating Ocular Contusion Caused by a High-Pressure Washer: A Case Report
This report details a rare case of a high-pressure washer injury that caused ocular contusion, vitreous hemorrhage, and irreversible corneal edema without perforation necessitating corneal transplantation. The medical chart of a patient with a high-pressure washer injury at Miyata Eye Hospital (Miyazaki, Japan) was retrospectively reviewed. A 57-year-old man presented to our hospital with a contusion in the left eye caused by a high-pressure washer 1 day prior to the visit. The visual acuity in the left eye was hand motion. Slit-lamp examination of the left eye revealed the presence of corneal epithelial defects, conjunctival lacerations, hyphema, and lacerated iris. Mild clouding of the lens was observed in the anterior chambers, suggestive of cataract. Anterior segment optical coherence tomography revealed the presence of blood in the anterior chamber and a thickened and edematous cornea. Ultrasound examination revealed the presence of vitreous hemorrhage. Therefore, vitreous surgery and traumatic cataract removal were performed under general anesthesia. Postoperatively, the corneal edema and marked opacity persisted, accompanied by glaucoma, and the visual acuity was measured at 0.01. Penetrating keratoplasty was performed 1 year and 2 months after the injury, and scleral fixation of the intraocular lens was performed under local anesthesia 2 years after the injury. The final visual acuity was 0.1 under rigid gas-permeable contact lens usage 3.5 years after sustaining the injury, and the patient required anti-glaucoma drugs. Our patient presented with ocular trauma caused by a high-pressure washer. Corneal transplantation was required although no ocular lacerations were detected. Sufficient instructions must be provided on the usage of heavy machinery to develop a safe working environment.
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