论文部分内容阅读
目的探讨视网膜脱离术后炎性巩膜坏死的原因、临床表现及治疗方法、方法报道５例视网膜脱离术后炎性巩膜坏死的发病及处理。结果５例孔源性视网膜脱离经巩膜外加压联合环扎术，术后１～３周发生炎性巩膜坏死，２例为金黄色葡萄球菌感染，３例为曲霉菌感染。去除外加压物，松解环扎带及清创处理后，４例炎症控制，１例经全板层角巩膜移植，病情发展致角膜坏死、眼内炎，最终行眼内容剜出。结论视网膜脱离术后炎性巩膜坏死主要与巩膜组织缺血、继发感染、以及局部免疫反应有关，治疗首先清除坏死组织，选择合适的抗生素及抗真菌药，辅以免疫抑制剂，必要时行异体巩膜移植。
Objective To investigate the causes, clinical manifestation and treatment of inflammatory scleral necrosis after retinal detachment. Methods The incidence and treatment of inflammatory scleral necrosis in 5 cases after retinal detachment were reported. Results 5 cases of rhegmatogenous retinal detachment by the scleral buckling combined with cerclage surgery, 1 to 3 weeks after the occurrence of inflammatory scleral necrosis, two cases of Staphylococcus aureus infection, three cases of Aspergillus infection. Four cases of inflammation were controlled after removal of extra pressure, loosening of zonal band and debridement treatment. One case was corneal scleral transplantation through full lamellar layer, and corneal necrosis and endophthalmitis were caused by the progression of the disease. Conclusions The inflammatory scleral necrosis after retinal detachment is mainly related to the scleral tissue ischemia, secondary infection and local immune reaction. The treatment is to remove the necrotic tissue first, select appropriate antibiotics and antifungal agents, supplemented with immunosuppressive agents, if necessary, Allogeneic scleral transplantation.