관상동맥우회술 후 발생한 양안의 각막절개창 파열과 홍채탈출 1예

A Case of Bilateral Corneal Wound Dehiscence With Iris Prolapse After Coronary Bypass Surgery

Purpose: To report a case of bilateral corneal wound dehiscence with iris prolapse after coronary artery bypass surgery. Case summary: A 65-year-old woman complained of sudden bilateral vision loss. Slit lamp microscope examination showed bilateral corneal wound dehiscence, collapse of the anterior chamber and iris prolapse. The patient had a history of bilateral cataract surgery one-month earlier and a coronary artery bypass surgery one-day previously. The authors resutured the corneal wound and performed an emergency iris repositioning. Postoperative 1 day, the best corrected visual acuity (BCVA) was 0.3 in the right eye and hand motion in the left eye. Total hyphema was observed in the left eye. At postoperative 2 months, the right eye had a BCVA of 0.63 with a sutured state of the corneal wound, and the left eye had a BCVA of light perception with a clotted hemorrhage in the anterior chamber. Conclusions: When a patient with a history of a previous sutureless cataract surgery has a coronary bypass surgery under general anesthesia, corneal wound dehiscence and iris prolapse may occur. For those patients, the authors recommend suturing the corneal wound instead of sutureless cataract surgery. J Korean Ophthalmol Soc 2010;51(8):1146-1149