RESUMEN

Infectious scleritis by Pseudomonas aeruginosa is a well-known vision-threatening disease. In particular, scleral trauma following pterygium surgery may increase the risk of sclera inflammation. Surgical debridement and repair is necessary in patients who do not respond to medical treatments, such as topical and intravenous antibiotics. We reports herein the effectiveness of an autologous perichondrium conchal cartilage graft for infectious scleritis caused by Pseudomonas aeruginosa. This procedure was performed on four eyes of four patients with infectious scleritis who had previously undergone pterygium surgery at Gyeongsang National University Hospital (GNUH), Jinju, Korea from December 2011 to May 2012. Pseudomonas aeruginosa was identified in cultures of necrotic scleral lesion before surgery. The conchal cartilage perichondrium graft was transplanted, and a conjunctival flap was created on the scleral lesion. The autologous perichondrium conchal cartilage graft was successful and visual outcome was stable in all patients, with no reports of graft failure or infection recurrence. In conclusion, autologous perichondrium conchal cartilage graft may be effective in surgical management of Pseudomonal infectious scleritis when non-surgical medical treatment is ineffective. Further studies in larger, diverse populations are warranted to establish the effectiveness of the procedure.

Asunto(s)

Infecciones Bacterianas del Ojo/terapia , Infecciones por Pseudomonas/terapia , Pseudomonas aeruginosa/aislamiento & purificación , Esclerótica/cirugía , Escleritis/terapia , Infección de la Herida Quirúrgica/terapia , Antibacterianos/uso terapéutico , Autoinjertos , Cartílago/cirugía , Enfermedades Transmisibles , Desbridamiento , Infecciones Bacterianas del Ojo/etiología , Femenino , Humanos , Procedimientos Quirúrgicos Oftalmológicos , Complicaciones Posoperatorias , Infecciones por Pseudomonas/microbiología , Pterigion/cirugía , República de Corea , Esclerótica/trasplante , Escleritis/microbiología , Infección de la Herida Quirúrgica/microbiología , Trasplante Autólogo , Resultado del Tratamiento

RESUMEN

Purpose: To report a case of invasive aspergillosis presenting as acute angle closure glaucoma. Case: A 72-year-old male patient visited our clinic with decreased visual acuity and ocular pain on the right eye lasting for 3 d. His intraocular pressure was 42 mmHg in the right eye and 18 mmHg in the left eye. And, there was about 2 mm of exophthalmos, slight ptosis with decreased motility in all directions, conjunctival injection, moderate mydriasis with a relative afferent pupillary defect, and angle closure in the right eye. Orbital computed tomography and magenetic resonance imaging showed isotense mass involving right orbit and ethmoid sinus. Based on the biopsy, invasive aspergillosis was definitely diagnosed. Despite perfoming peripheral laser iridotomy and administrating antifungal agent and antiglaucoma medication, the patient was blinded in his right eye. During the follow-up period, visual acuity in the left eye suddenly decreased due to the invasive aspergillosis in the left paranasal sinus and optic nerve, and eventually the patient lost his left vision as well. Conclusion: This report is regarding a case of an invasive aspergillosis resulting in blindness in both eyes with the clinical manifestations of acute angle closure caused by invasive aspergillosis.