钳夹分娩后的 Descemet 膜撕裂

Josephine S Christy, A. Parab, Vaibhav Khanna
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摘要

:报告一例由产钳助产引起的角膜外伤系列病例:我们回顾并分析了六名患者的病例记录,这些患者的临床特征提示其角膜创伤是由产钳助产引起的。所有 6 名患者中,包括 2 名男性和 4 名女性,都发现了垂直至斜角的角膜德斯密特膜(DM)撕裂。所有患者均为右眼受累,其中一名患者为双眼受累。发病年龄从 5 岁到 39 岁不等。三名患者的患眼视力优于 6/18,三名患者的患眼视力劣于 6/18。所有患者的角膜散光度数都在 1.75 至 8 屈光度之间。 产科医生应尽早预料到阴道分娩的复杂性,并就分娩方式做出适当的决定,以避免可避免的眼外伤,尤其是在产钳助产的情况下。所有经阴道产钳助产的新生儿都必须转诊至眼科医生,以排除任何眼外伤。早期干预可避免因弱视导致的不可逆转的视力损失。
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Descemet’s membrane tears following forceps delivery
: To report a case series on corneal trauma induced by forceps assisted vaginal delivery.: Case records of six patients who had clinical features suggestive of corneal trauma induced by forceps delivery were retrospectively reviewed and analysed. Vertical to oblique corneal Descemet’s membrane (DM) tears were noted in all 6 patients which included 2 males and 4 females. Right eye was involved in all patients and one patient had bilateral involvement. The age of presentation ranged from 5 to 39 years. Three patients had visual acuity better than 6/18 and three had worse than 6/18 in their affected eyes. All patients had corneal astigmatism in the range of 1.75 to 8 diopters. : A complicated vaginal delivery should be anticipated at the earliest by the obstetrician and an apt decision on the mode of delivery has to be attempted in order to prevent avoidable ocular trauma, especially in forceps assisted vaginal deliveries. All neonates who are born by forceps assisted vaginal delivery require mandatory referral to an ophthalmologist to rule out any ocular trauma. Early intervention can prevent irreversible vision loss due to amblyopia.
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