Intraoperative B-scan ultrasonography and pars plana vitrectomy for severe open globe injury with hemorrhagic retinal and choroidal detachment

Purpose: Presumed venous air embolism (PVAE) is a rare and potentially fatal complication of pars plana vitrectomy that is poorly described and understood but requires improved awareness among ophthalmologists and vitreoretinal surgeons. Methods: A case report is presented along with a systematic review of published reports of PVAE during ocular surgery. Results: An otherwise healthy adult male undergoing retinal detachment repair under local anesthesia with monitored anesthesia care died from a PVAE. Literature search yielded 2 experimental models, 6 individual case reports, and several editorials. Review of existing reports reveals that PVAE can affect patients of any age or gender with no medical predilection and occurs in cases of trauma, endoresection, or retinal detachment repair. It is typically associated with a drop in end-tidal carbon dioxide during fluid–air exchange and can present similar to a hemorrhagic choroidal detachment. Analysis suggests that venous air embolism can be prevented by ensuring full engagement of the infusion cannula into the vitreous cavity prior to fluid–air exchange. Conclusion: Presumed venous air embolism is a potentially fatal complication of ocular surgery and in some cases may be recognized by ophthalmologists as a choroidal detachment during fluid–air exchange in pars plana vitrectomy. It is imperative to immediately stop the air infusion line if venous air embolism is suspected.

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Outcomes of 23-gauge pars plana vitrectomy combined with phacoemulsification and capsulotomy without intraocular lens implantation in rhegmatogenous retinal detachment associated with choroidal detachment

Medicine ◽

10.1097/md.0000000000007869 ◽

2017 ◽

Vol 96 (34) ◽

pp. e7869 ◽

Cited By ~ 1

Author(s):

Huiyan Xu ◽

David Lutrin ◽

Zhifeng Wu

Keyword(s):

Retinal Detachment ◽

Intraocular Lens ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Intraocular Lens Implantation ◽

Choroidal Detachment ◽

Lens Implantation ◽

Pars Plana ◽

23 Gauge

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Party Poppers and Balloons: Fun and Games or Lives and Limbs?

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i1.975 ◽

2020 ◽

Vol 36 (2) ◽

Author(s):

Fiza Shaheen ◽

Rehan Naqaish ◽

Muhammad Amer Awan

Keyword(s):

Ocular Trauma ◽

Vitreous Hemorrhage ◽

Open Globe Injury ◽

Lens Extraction ◽

Safety Awareness ◽

Full Thickness Macular Hole ◽

Open Globe ◽

Awareness Programs ◽

Pars Plana ◽

Popular Party

Abstract We report two cases of ocular trauma caused by recently popular party poppers and LED balloons, commonly used in parties nowadays. One case depicted a closed globe injury as a result of a party popper spray over the eye. The pressure of the spray resulted in a blunt trauma causing full thickness macular hole which was later treated with Pars Plana Vitrectomy (PPV) surgery. The second case is an example of an open globe injury caused by the bursting of LED balloon over the eye of a young child resulting in corneal perforation, traumatic cataract, vitreous hemorrhage with an intraocular foreign body (IOFB). It was successfully treated with corneal suturing, lens extraction, PPV surgery and removal of IOFB followed by a secondary lens implantation. Both of the sustained injuries were completely avoidable hence emphasizing the requirement of eye safety awareness programs and diligence in the use of these gadgets in everyday lives.

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Outcome and Prognostic Factors for Traumatic Endophthalmitis over a 5-Year Period

Journal of Ophthalmology ◽

10.1155/2014/747015 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 12

Author(s):

Simona Delia Nicoară ◽

Iulian Irimescu ◽

Tudor Călinici ◽

Cristina Cristian

Keyword(s):

Prognostic Factors ◽

Medical Records ◽

Pars Plana Vitrectomy ◽

Light Perception ◽

Delayed Treatment ◽

Ocular Lesions ◽

Open Globe ◽

Pars Plana ◽

Inflammatory Drugs ◽

Open Globe Injuries

Purpose. To evaluate the outcome and identify the prognostic factors of traumatic endophthalmitis over a 5-year period.Methods. We reviewed the medical records of all the traumatic endophthalmities that we treated in our department over the last 5 years (2009–2013). We extracted the following parameters: age, gender, wound anatomy, associated ocular lesions, treatment, and initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data.Results. During the last 5 years, we treated 14 traumatic endophthalmities, representing 46.66% of all types of endophthalmities. The infection rate in open globe injuries was 8.13% and 34.78%, if an intraocular foreign body (IOFB) was associated. All the patients were males with the median age of 37 years. Initial visual acuities varied between light perception and 0.4 and the timing of treatment from a few hours to 10 days. We administered antibiotic and anti-inflammatory drugs, systemically and intravitreally, in all cases. We performed pars plana vitrectomy in 64.28% of cases. In 57.14% of cases, the final visual acuity was 0.1 or more.Conclusions. IOFBs increased significantly the risk for endophthalmitis. The worse prognostic factors were retinal detachment at presentation and delayed treatment. This trial is registered withIRCT2014082918966N1.

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Pars Plana Vitrectomy following Traumatic Ocular Injury and Initial Globe Repair: A Retrospective Analysis of Clinical Outcomes

Military Medicine ◽

10.1093/milmed/usaa286 ◽

2021 ◽

Vol 186 (Supplement_1) ◽

pp. 491-495

Author(s):

Hunter H Phillips ◽

Halward J Blegen IV ◽

Christopher Anthony ◽

Brett W Davies ◽

Marissa L Wedel ◽

...

Keyword(s):

Visual Acuity ◽

Retrospective Analysis ◽

Pars Plana Vitrectomy ◽

Ocular Trauma ◽

Ocular Injury ◽

Complication Rates ◽

Vitreoretinal Disease ◽

Open Globe ◽

Initial Injury ◽

Pars Plana

ABSTRACT Introduction Penetrating and perforating ocular trauma are often devastating and may lead to complete visual loss in the traumatized eye and subsequent compromise of the fellow eye. A significant proportion of traumatic injuries are complex, often requiring vitreoretinal intervention to preserve vision. A retrospective analysis at a level 1 trauma center was performed to evaluate the time course, incidence, and outcomes following pars plana vitrectomy (PPV) after traumatic ocular injury and initial globe repair. Materials and Methods Eyes that underwent open globe repair following ocular trauma at Brooke Army Medical Center, between January 1, 2014 and December 30, 2016 were analyzed. Specific factors evaluated include mechanism of injury, defect size and complexity, ocular trauma score, zone of injury, associated orbital trauma, and time from injury to surgical intervention. A subset analysis was conducted specifically on eyes requiring subsequent PPV for vision preservation because of vitreoretinal disease. Surgical outcomes, time to secondary intervention, and complication rates were then assessed. Results In total, 70 eyes requiring open globe repair were examined, with 43 having undergone PPV. Average and median time to vitrectomy were 18.8 and 8 days, respectively. Eyes that underwent PPV were more likely to have an afferent papillary defect, vitreous hemorrhage, intraocular foreign body, and retinal detachment at the time of initial injury (although the latter two factors were not statistically significant), and were more likely to receive penetrating keratoplasty. Proliferative vitreoretinopathy occurred in 37.2% of eyes that underwent PPV, versus 3.7% of those that did not (P = 0.0013). Timing of PPV (i.e., before or after 14 days) had no statistically significant effect on the rate of PVR (Table I). Eyes that underwent PPV showed an improvement of visual acuity from average 2.5 logMAR following initial injury to 1.5 logMAR 6 months after PPV, equivalent to 18.7 Early Treatment Diabetic Retinopathy Study (ETDRS) letters gained, versus 37.7 ETDRS letters gained in eyes without PPV. Among PPV eyes, early repair (<14 days) was associated with greater improvement in visual acuity. Conclusion Overall, patients requiring PPV following open globe repair generally had more severe injuries and worse 6-month postoperative visual acuity. Patients who underwent more expedited vitrectomy showed greater improvement in visual acuity as measured by ETDRS letters gained.

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