Combined Anterior Sclera Staphylectomy and Vitrectomy with Anterior Sclera Staphyloma and Vitreous Hemorrhage Occurring 38 Years after Cataract Surgery
Figure 1
Clinical photograph, ultrasonographic fundus photograph and histopathology of right eye. (a) A brown protruding bulge occupied the entire nasal quadrant with a clear boundary seen at the outer edge of the corneoscleral limbus. The cornea was transparent, the anterior chamber was shallow and about 1/3CK, the pupil shifted up and dwindled with an apparent discoria. (b) B-scan showed vitreous opacity with posterior vitreous detachment. (c) The bulbar conjunctiva around the anterior staphyloma on the superior nasal quadrant was separated; the prolapsed uveal tissues and vitreous body were pruned during operation. (d) After surgical removal of the anterior staphyloma, the apparent thinning and perforated sclera at 12:00–2:30 position and iridoleptynsis on the superior nasal quadrant was observed. (e) The shifted-up iris was cut to recover a circular pupil and to clear vitreous hemorrhage by vitrectomy. (f) The removed specimens were confirmed as anterior staphyloma with the existence of pigment cells (arrowhead) by pathological examination. (g, h) Re-examination three months after operation: the right cornea was transparent, the stitches of corneoscleral junction on the superior nasal quadrant were eutopic, the anterior chamber was deep and the pupil was circular; the retina was procumbent by Panoramic200.
