[Frequency of corneal ulcer: Retrospective study of 380 cases carried out in two centers in the DR Congo]

Misdiagnosis and Treatment of Corneal Complications Caused by Suture Exposure After Buried-Suture Double-Eyelid Blepharoplasty

PURPOSE

The purpose of this study was to summarize the misdiagnosis and treatment of corneal complications associated with suture exposure in cases of buried-suture double-eyelid blepharoplasty.

METHODS

This study retrospectively analyzed 14 patients with palpebral conjunctival and corneal complications due to suture exposure after buried-suture double-eyelid blepharoplasty at the First Affiliated Hospital of Harbin Medical University from January 2020 to July 2022. The patients' clinical symptoms included photophobia, lacrimation, pain, foreign body sensation, swelling of the eyelids, conjunctival hyperemia, secretion, etc. We recorded the patient's sex, age, surgical method, length of exposed suture, suture type, number of double-eyelid surgeries, surgical site, timepoint when eye discomfort occurred, misdiagnosed disease and treatment.

RESULTS

Three patients were misdiagnosed with dry eye, nine patients were misdiagnosed with viral keratitis, and two patients were misdiagnosed with allergic conjunctivitis. All 14 patients had manifestations of photophobia, lacrimation, pain, foreign body sensation and conjunctival hyperemia. Eight patients had manifestations of swelling of the eyelids. Five patients had manifestations of eye secretions. There were 8 patients with corneal epithelial injuries and 6 patients with corneal ulcers. All patients underwent suture removal without further progression. Ten patients were treated with artificial tears, and 4 patients were treated with calf serum deproteinized gel after suture removal.

CONCLUSION

If there is postoperative eye discomfort caused by eyelid and corneal complications in patients after buried-suture double-eyelid blepharoplasty, clinicians should carefully check whether there is suture exposure and determine the cause in a timely manner. Suture removal is the best way to treat this complication.

LEVEL OF EVIDENCE IV

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Altered spontaneous brain activity patterns in patients with corneal ulcer using amplitude of low-frequency fluctuation: An fMRI study

The aim of the present study was to investigate the altered spontaneous brain activity in patients with corneal ulcer (CU) through the amplitude of low-frequency fluctuation (ALFF) technique and the association with their visual performance. A total of 40 patients with CU and 40 healthy controls (HCs) matched for sex, age and educational level were enrolled. Resting-state functional magnetic resonance imaging (rs-fMRI) was performed to examine the probands. Spontaneous cerebral activity variations were investigated using the ALFF technique. The average ALFF values of the CU patients and the HCs were classified by utilizing receiver operating characteristic (ROC) curves. Contrary to HCs, the CU patients had significantly lower ALFF values in the left cerebellar anterior lobe, right middle frontal gyrus and left middle frontal gyrus, but higher ALFF values in the right cerebellar inferior lobe, left cerebellar inferior lobe, left inferior temporal gyrus, right fusiform gyrus, left superior frontal gyrus, right angular gyrus and bilateral superior frontal gyrus. ROC curve analysis of each brain region indicated that the accuracy of ALFF value specificity between the CU and HCs of the area under the curve was perfect. In conclusion, abnormal spontaneous activities were detected in numerous brain regions of CU patients, which may provide useful information for understanding the dysfunction of CU. These activity changes in brain regions may be used as effective clinical indicators for CU.