Surgical treatment of paralytic mydriasis caused by belladonna preparation intake (a clinical case)
Year: 2024, volume 20 Issue: №3 Pages: 255-258
Heading: Ophthalmology Article type: Case report
Authors: Sobolev N.P., Teplovodskaia V.V., Petukhova A.A., Sudakova E.P.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Heading: Ophthalmology Article type: Case report
Authors: Sobolev N.P., Teplovodskaia V.V., Petukhova A.A., Sudakova E.P.
Organization: The S. Fyodorov Eye Microsurgery Federal State Institution
Summary:
This rare clinical case demonstrates the treatment of paralytic mydriasis caused by taking a herbal drug, Atropa belladonna, which is extremely rare in the treatment of diseases today, using sequential implantation of an intraocular lens (IOL) and an artificial iris with simultaneous correction of refractive errors. The patient took Atropa belladonna extract for 5 years to prevent exacerbation of gastric ulcer according to the scheme 2 times a year (spring, autumn) for 2 weeks, 5-7 drops 3 times a day with meals. The uniqueness is explained by the fact that paralytic mydriasis arose as a result of long-term drug exposure. Analysis of the state of the iris stroma showed the impossibility of performing suture plasty of the pupil. In addition, patients with this pathology have been denied treatment in other medical institutions for decades.
Keywords: artificial iris, Atropa belladonna, complicated cataract, paralytic mydriasis, sequential implantation
Bibliography:
1. Wilhelm Н, Wilhelm В, Schiefer U. Mydriasis durch Pflanzenkontakt [Mydriasis caused by plant contact]. Fortschr Ophthalmol. 1991; 88 (5): 588-91. (In German.) PMID: 1757054
2. Havelius U, Asman P. Accidental mydriasis from exposure to Angel's trumpet (Datura suaveolens). Acta Ophthalmol Scand. 2002; 80 (3): 332-5. DOI: 10.1034/j. 1600-0420.2002.800319. x
3. Kwakye GF, Jimenez J, Jimenez JA, Aschner M. Atropa belladonna neurotoxicity: Implications to neurological disorders. Food Chem Toxicol. 2018; 116 (Pt B): 346-53. DOI: 10.1016/j. fct. 2018.04.022
4. Zeng L, Zhang Q, Jiang C, et al. Development of Atropa belladonna L. plants with high-yield hyoscyamine and without its derivatives using the CRISPR/Cas9 system. Int J Mol Sci. 2021; 22 (4): 1731. DOI: 10.3390/ijms22041731
5. Mateo Montoya A, Mavrakanas N, Schutz JS. Acute anticholinergic syndrome from Atropa belladonna mistaken for blueberries. Eur J Ophthalmol. 2009; 19 (1): 170-2.
6. Kaiti R, Shyangbo R, Sharma IP. Role of atropine in the control of myopia progression —A review. Beyoglu Eye J. 2022; 7 (3): 157-66. DOI: 10.14744/bej. 2022.07742
7. Thuma TBT, Bello NR, Rapuano CJ, Wasserman BN. Resolution of traumatic mydriasis and accommodative dysfunction eight years after sweetgum ball ocular injury. Am J Ophthalmol Case Rep. 2022; 26: 101552. DOI: 10.1016/j. ajoc. 2022.101552
8. Shanturova MA. Method for eliminating of mydriasis: patent No. 2562014 C2 dated 10.09.2015. Bulletin No. 25. URL: https://rusneb.ru/catalog/000224_000128_00025620 14_20150910_C2_RU/(18 Dec 2023).
9. Pozdeeva NA, Pashtaev NP. Artificial iridolenticular diaphragm in the surgical treatment of aniridia. Cheboksary: Cheboksary branch of the Federal State Budgetary Institution "Eye Microsurgery" n. a. Acad.S. N. Fedorov Ministry of Health and Social Development of the Russian Federation, 2012; 160 p.
| Attachment | Size |
|---|---|
| 2024_03_255-258.pdf | 772.89 KB |
Русский
English