Current Concepts and Management of Severely Traumatized Tissues in the Inner Coatings (The Posterior Segment: The Ciliary Body, the Choroid, and the Retina) of the Globe: Mechanical Injuries (Open Globe Without Intraocular Foreign Body and Without Endophthalmitis)

Author(s):  
Gokhan Gurelik ◽  
Sabahattin Sul
Author(s):  
Stephen Weiss ◽  
Dustin Williams ◽  
Yih Ying (Eva) Yuan ◽  
Jo-Ann Nesiama

2020 ◽  
pp. 247412642096503
Author(s):  
Filippos Vingopoulos ◽  
Yvonne Wang ◽  
Seanna Grob ◽  
Chloe Yang Ling Li ◽  
Dean Eliott ◽  
...  

Purpose: To investigate characteristics of Open Globe Injuries (OGI) that presented with Intra-Ocular Foreign Body (IOFB), along with their long-term visual outcomes and complications. Methods: Retrospective interventional consecutive case series of OGIs with IOFBs that presented at Massachusetts Eye and Ear from 2010 to 2015. Data collected included time from injury to OGI repair, location of IOFB, retinal detachment (RD) rate, presenting and final visual acuity and subsequent surgeries. Results: Fifty-seven consecutive cases of OGIs with IOFBs were included. Mean follow-up was 28 months and median time from injury to OGI repair was 0 days. Overall, 38/57 (66.7%) eyes achieved final vision of 20/40 or better and 43/57 (75.4%) 20/150 or better. Thirty-three cases had IOFBs in the anterior segment only, 24 cases had posterior segment involvement. Thirty percent of cases (17/57) were complicated by an RD, 58.3% (14/24) in the posterior versus 9.1% (3/33) in the anterior IOFB group ( P = .01). There were no cases of endophthalmitis. Posterior IOFB and higher zone of injury were risk factors for RD both at presentation (both P < .001) and post-primary repair (both P < .001). Posterior IOFB was associated with higher vitrectomy rates both at presentation ( P < .001) and post-primary repair ( P = .002) and worse long-term visual outcome ( P = .01). Conclusions: OGIs with IOFB involving the posterior segment are associated with higher complication and re-operation rates and worse visual prognosis compared to those involving the anterior segment only.


2007 ◽  
Vol 246 (1) ◽  
pp. 161-165 ◽  
Author(s):  
Zsuzsanna Szijártó ◽  
Valéria Gaál ◽  
Bálint Kovács ◽  
Ferenc Kuhn

Author(s):  
Luis Filipe Nakayama ◽  
Vinicius Campos Bergamo ◽  
Nilva Simeren Bueno de Moraes

Abstract Background To evaluate the epidemiology of endophthalmitis cases related to ocular trauma, including visual acuity during and 1 year after trauma, source of trauma and method of treatment. Methods A retrospective study analyzed the epidemiological data of patients with a clinical presentation of endophthalmitis after ocular penetrating trauma between January 2012 and January 2017 at Escola Paulista de Medicina/UNIFESP, a hospital in São Paulo, SP, Brazil. Results A total of 453 patients with antecedent open globe trauma were evaluated, among these, 30 patients with suspected endophthalmitis. All patients were male. The time interval between trauma and ophthalmological evaluation and collection of vitreous and aqueous material was 1 day in 36.66%, 2–7 days in 43.44%, 7–14 days in 10% and more than 15 days in 10% of patients; 66.66% had positive cultures. 11 patients had intraocular foreign body. One year after trauma, visual acuity was classified as no light perception (NLP) in 33.33%, light perception in 6.66%, hand motion in 13.33%, counting fingers in 13.33%, and better than 20/400 in 20% of patients. Considering presence of intraocular foreign body, initial visual acuity and symptoms onset time, only initial visual acuity showed as better prognostic factor in final visual acuity. Conclusion Endophthalmitis is a severe ocular inflammatory condition that may lead to irreversible vision loss. Initially only one patient had visual acuity of NLP, but after 1 year, 33% showed visual acuity of NLP, and only 20% had visual acuity better than 20/400, what is consistent with a severe infection with a guarded prognosis. The high incidence of endophthalmitis after ocular penetrant trauma justifies distinct treatment and greater attention.


2018 ◽  
Vol 10 (1) ◽  
pp. 66-72 ◽  
Author(s):  
Sanjita Sharma ◽  
Raba Thapa ◽  
Sanyam Bajimaya ◽  
Eli Pradhan ◽  
Govinda Poudyal

Purpose: To evaluate clinical characteristics, visual outcomes and globe survival after intraocular foreign body removal from posterior segment via pars plana approach. Methods: A hospital based retrospective study. All the patients of penetrating eye injury with intraocular foreign body in posterior segment as detected by computed tomography were enrolled from 2012 to 2014.Results: Thirty patients of 30 eyes were included. The mean age was 27.7 years. (2-52). Twenty-four (80%) were male. Out of 30 eyes 19 (63.3%) eyes had injury at Zone 1 and 11 (36.7%) eyes had injury at Zone 2. The mean time spent between primary repair following surgery and intra ocular foreign body removal, was 15.47 days. Retinal detachment and endophthalmitis prior to intraocular foreign body removal was present in 9/30 of eyes. We looked for correlation between post operative Phthisis bulbi with zone of injury and pre operative endophthalmitis and preoperative retinal detachment. However, p value for the above correlation was more than 0.552 and 0.815 respectively, which was statistically not significant.Conclusions: The eyes with posterior segment intraocular foreign bodies showing clinical features of preoperative endophthalmitis, retinal detachment and the zone of injury also did not have any direct significance with globe survival.  


2020 ◽  
Vol 8 (5) ◽  
pp. 375-378
Author(s):  
Dr. Amit C Porwal ◽  
◽  
Dr. Hardik Jain ◽  
Dr. Pratik Mahajan ◽  
◽  
...  

Intraocular foreign bodies (IOFBs) are an important cause of visual loss. The current case describesa case of retained intraocular foreign body with secondary retinal detachment in a phakic eye in a38-year-old man. The foreign body was safely removed through the sclerotomy port withouttouching the crystalline lens. The current case report wanted to show the anatomic and visualoutcomes of vitreoretinal surgery in such cases.


2018 ◽  
Vol 5 (2) ◽  
pp. 45-48
Author(s):  
Ritesh Kumar Shah ◽  
Raghunandan Byanju ◽  
Sangeeta Pradhan

AIM: To evaluate the anatomical and visual outcome following removal of intraocular foreign body (IOFB) through pars planavitrectomy.MATERIAL & METHODS: A retrospective analysis of 11 cases of retained posterior segment foreign body that underwent pars planavitrectomy for removal of foreign body during the period of January 2013 to August 2017 was conducted. Demographics of patients, mechanism and details of injury, Snellen best corrected visual acuity, examination results at presentation and after surgery, any diagnostic imaging and surgical procedure were recorded and analysed.RESULTS: Out of eleven eyes of eleven patients (mean age= 25.4}8.6, range 22 50 years; all male) preoperative retinal detachment and endophthalmitis was seen in 27.3% and 36.4% of cases respectively. Eighty-two percent of cases presented within 17 days of sustaining injury. Foreign body size ranged from 2mm to 8 mm and all were magnetic metal. After vitrectomy and removal of foreign body, the number of eyes with vision of hand motion or worse decreased from 72.7% to 27.3%. Similarly 45.5% of eyes gained best corrected postoperative visual acuity of better than 6/60. Anatomical success could be achieved in 81.8% of eyes.CONCLUSION: Anatomical outcome following vitrectomy in eyes with retained posterior segment IOFB in terms of retinal attachment is sufficient; however, visual outcome can be affected by other collateral ocular injuries and their sequelae.Journal of Universal College of Medical Sciences, Vol. 5, No. 2, 2017, Page: 45-48 


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