在白内障患者中不适当地注射米托米辛
Gibran Merchant1, Aaron DeWeerd1, Jackson Mooney1
1Kansas Health Science University, Kansas College of Osteopathic Medicine, 217 E. Douglas Ave, Wichita, KS, 67202, USA.
American journal of ophthalmology case reports
|June 11, 2025
概括
在白内障手术后,错误的室内线内线粒素注射导致83岁男性的视力丧失. 这一案例凸显了关键系统故障以及需要加强安全措施,以防止眼科手术中出现这种"永远不会发生"的情况.
科学领域:
- 眼科医生 眼科 眼科
- 患者安全 患者安全
- 手术并发症 手术并发症
背景情况:
- 白内障手术是一种常见的手术,并发症率低.
- 眼科手术期间的药物错误可能导致严重的视力障碍.
- 系统性故障可能会导致不良事件,尽管已建立的协议.
研究的目的:
- 在白内障提取后报告一例不当的室内米托米辛注射情况.
- 强调系统改进的必要性,以防止严重的药物错误 ("永远不会发生").
- 要突出与非标签药物使用和眼科手术中复合药物使用相关的风险.
主要方法:
- 一个83岁的男性患者的病例报告.
- 对临床表现,手术程序和术后过程的审查.
- 调查意外视力下降和眼部炎症的原因,包括TASS评估.
主要成果:
- 在技术上不复杂的白内障手术之后,逐渐出现视力丧失,光恐惧症,角膜胀和眼内压力升高.
- 调查显示,由于药物制备错误,无意中在室内注射了米托米辛,而不是塞福洛キシ姆.
- 米托米的眼内毒性导致了不可逆转的视力丧失.
结论:
- 系统故障,包括药物混合,即使使用现有协议,也可能导致严重的不良事件 ("永远不会发生").
- 加强安全措施,如改善药物标签和持续使用外科手术暂停时间至关重要.
- 建议尽量减少非标签药物的使用,并寻求FDA批准的眼内抗生素用于白内障手术.
相关概念视频
01:28Angle Closure Glaucoma: Treatment
451
Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...
451
01:27Open Angle Glaucoma: Treatment
406
In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...
Drugs such as carbonic anhydrase inhibitors, α2- and...
406