Effective Treatment of Epithelial Downgrowth in Persistent Wound Leak Following Removal of Silicone Oil

摘要

This case report aims to share the successful management of Epithelial Downgrowth (ED) which occurred following persistentwound leak, after Removal of Silicone Oil (ROSO) via the anterior chamber. A teenage male with history of high myopia underwentbilateral phacoemulsifcation and implantation of Multifocal Intraocular Lens (MFIOLs). Four months later, he complained of left eye?oaters and blurring of vision. Fundus showed left vitreous haemorrhage with lens subluxation. Left 23 gauge pars plana vitrectomyrevealed multiple retinal tears. Endolaser and gas injection with MFIOL repositioning was done. Retinal redetachment and MFIOLsubluxation occurred six weeks postoperatively. Revision vitrectomy with silicone oil and explantation of MFIOL was performedrendering left eye aphakic. Four months later, he underwent ROSO via a superior corneal incision. Positive Seidels was seen twoweeks post-ROSO and resuturing was performed. Unfortunately, advancing ED was noted at the superior cornea. One monthafter ROSO, scleral fxated IOL implantation with manual removal of ED and intracameral injection of 5-?uorouracil (5-FU) wereperformed. Twelve months postoperatively, cornea remained clear with a pinhole vision of 6/7.5 and retina was ?at. In conclusion,wound leak after ROSO via the anterior chamber in aphakic individuals may predispose to ED. Key to treatment of this sightthreatening condition is thoughtful anterior segment examination. Manual removal of the membrane combined with 5-FU injectionduring secondary lens implantation surgery is an effective treatment.