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: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A 5-Year Retrospective Analysis of the Risk Factors, Treatment, and Prognosis of Patients With Fungal Keratitis in Heilongjiang, China.

PURPOSE: To report the epidemiologic features, laboratory findings, and treatment outcomes of patients with fungal keratitis (FK) during a busy farming period (May, June, and September to November) in Heilongjiang Province, China. DESIGN: Retrospective, observational case series. METHODS: In total, 251 patients diagnosed with FK at the Eye Hospital, First Affiliated Hospital of Harbin Medical University, from 2017 to 2021 were identified. Medical records were retrospectively analyzed, and demographic features, risk factors, monthly distributions, clinical characteristics, laboratory findings, treatment strategies, and prognostic data were collected. RESULTS: The number of FK cases in the busy farming period accounted for 74.1% (186/251) of the total. The mean patient age was 58.2±9.5 years. Males (66.7%) were more likely to develop FK than females (33.3%), and plant-related trauma was the main cause in 80.1% (149/186) of the cases. The most common causative fungal species was Fusarium (34.9%). In vivo confocal microscopy had the highest positivity rate for FK diagnosis (94.6%). The depth of hypopyon, depth of hyphae or spores, and infiltrate width were significantly positively correlated with delayed presentation. CONCLUSIONS: Patients with a longer time of presentation to the hospital were more likely to undergo surgery because of topical medical therapy failure. The most important measures for FK prevention are the use of eye protection during outdoor work and visiting the hospital for treatment as soon as possible after eye injury.