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A case of atopic retinal detachment with unusual ocular surface inflammation after scleral buckling Hideto Sakaguchi 1 , Isana Nakajima 1,2 , Takashi Nishiuchi 1 , Yusaku Miura 1 , Tamaki Sumi 1 , Ken Fukuda 1 , Kenji Yamashiro 1 1Department of Ophthalmology, Kochi Medical School, Kochi University 2Department of Ophthalmology, Cancer Institute Hospital of JFCR pp.712-716
Published Date 2025/6/15
DOI https://doi.org/10.11477/mf.037055790790060712
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Abstract Background:Patients with atopic dermatitis(AD)often develop various ocular diseases known as atopic eye disease, affecting not only the skin but also the eyes.

Case:The patient was a 19-year-old male with a history of AD since childhood. He presented with retinal detachment in his right eye and underwent scleral buckling surgery. On the day after the surgery, he experienced worsening conjunctival hyperemia, edema, and eyelid swelling. Although eye drops were increased on the 6th postoperative day, there was no improvement, and excision of excess conjunctiva was performed on the 10th postoperative day. On the 12th postoperative day, eye discharge and hyperemia further worsened. Suspecting an allergy or infection related to the silicone sponge, the silicone sponge was removed from the right eye on the same day. The sclera at the location where the silicone sponge was sutured was thinned, and significant proliferation of the surrounding Tenon's and subconjunctival tissues was observed. MRSA was detected in both the eye discharge and the silicone sponge cultures. Methylprednisolone 250 mg infusion was added for 3 days from the day after the surgery, resulting in a rapid improvement in conjunctival hyperemia and eyelid swelling.

Conclusions:We report a case of an AD patient who developed severe anterior segment inflammation the day after scleral buckling surgery for retinal detachment, which improved after removal of the silicone sponge. While the impact of infection cannot be ruled out, there were no strong signs of infection such as abscess formation. Therefore, the primary pathology was considered to be an allergic reaction to the scleral buckling silicone sponge or sutures. It is important to consider the possibility of allergy in cases of persistent hyperemia and eyelid swelling after scleral buckling surgery.


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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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