Indications, Findings, and Outcomes of Pars Plana Vitrectomy after Open Globe Injury

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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Combined Penetrating Keratoplasty Followed by Pars Plana Vitrectomy for Firecracker Induced Bilateral Corneal and Intraocular Foreign Body: A Case Report

Journal of Nepal Medical Association ◽

10.31729/jnma.4932 ◽

2020 ◽

Vol 58 (226) ◽

Author(s):

Lily Rajbanshi ◽

Archana Kumari ◽

Sanjay Singh

Keyword(s):

Foreign Body ◽

Pars Plana Vitrectomy ◽

Penetrating Keratoplasty ◽

Hand Movement ◽

Intraocular Foreign Body ◽

Corrected Visual Acuity ◽

Open Globe ◽

Pars Plana ◽

The Right ◽

Open Globe Injuries

Firecracker induced open globe injury is a big challenge for ophthalmic surgeons. Its associationwith the intraocular foreign body makes the diagnosis and treatment even more difficult resultingin poor anatomical and visual outcomes. We report a case of a 35-year-old male who presented withbilateral, multiple corneal and intraocular foreign body due to firecracker explosion. His vision waslimited to hand movement in both eyes. Combined penetrating keratoplasty and cataract surgerywere done in both eyes followed by pars plana vitrectomy for intraocular foreign body removal.The final best-corrected visual acuity of the patient stood to be 6/6 and 6/9 in the right and left eyerespectively. The encouraging result in our case prompts ophthalmologists for a timely stepwisemultidisciplinary approach in all open globe injuries with intraocular foreign body cases havingpoor initial acuity.

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Perfluorocarbon liquid-assisted intraocular foreign body removal

Malaysian Journal of Ophthalmology ◽

10.35119/myjo.v3i2.190 ◽

2021 ◽

Vol 3 (2) ◽

pp. 120-126

Author(s):

Hui Wen Lim ◽

Suyi Siow ◽

Kiet Phang Ling

Keyword(s):

Foreign Body ◽

Pars Plana Vitrectomy ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Surgical Techniques ◽

Intraocular Foreign Body ◽

Ocular Injury ◽

Perfluorocarbon Liquid ◽

Open Globe ◽

Pars Plana

Traumatic ocular injury is an uncommon yet leading cause of monocular blindness among the working-age group. Retained intraocular foreign body (IOFB) are associated with 41% of open globe injuries. Pars plana vitrectomy is often required for posterior segment IOFB removal. Advances in vitreoretinal surgical techniques and instrumentation have resulted in better treatment outcomes with reduced ocular morbidity. We report a case of modified ILM forceps with perfluorocarbon liquid-assisted non-magnetic IOFB removal in a young man after a motor vehicle accident with zone one open globe injury and a large glass IOFB in the right eye. We describe the use of perfluoro-N-octane to slide the IOFB extramacularly and reorient the IOFB plane for stable and safe retrieval by ILM end-gripping forceps. The modified design of the ILM end-gripping forceps with adjunctive use of perfluorocarbon liquid in pars plana vitrectomy reduces slippage during IOFB extraction and prevents collateral iatrogenic retinal injury.

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Primary Combined Pars Plana Vitrectomy and Phacoemulsification With Anterior Segment Removal of Posterior Segment Intraocular Foreign Bodies: A 30-Month Longitudinal Study

Journal of VitreoRetinal Diseases ◽

10.1177/2474126418759764 ◽

2018 ◽

Vol 2 (2) ◽

pp. 79-86

Author(s):

Razek Georges Coussa ◽

Fares Antaki ◽

Ali Dirani ◽

Thomas Cordahi ◽

Radwan Ajlan ◽

...

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Pars Plana Vitrectomy ◽

Rhegmatogenous Retinal Detachment ◽

Foreign Bodies ◽

Anterior Segment ◽

Posterior Segment ◽

Long Term Results ◽

Open Globe ◽

Pars Plana

Purpose: To describe a surgical technique and report visual and anatomical outcomes after primary combined pars plana vitrectomy (PPV) and phacoemulsification in patients with posterior segment intraocular foreign bodies (IOFBs) removed via the anterior chamber without enlarging preexisting sclerotomies. Posterior IOFBs are generally managed in a stepwise surgery consisting of phacoemulsification/lensectomy for traumatic cataract removal then PPV and removal of IOFB through enlarged sclerotomies. Enlarged sclerotomies may carry a significant risk of hypotony, vitreous hemorrhage, vitreous and retinal incarceration, and rhegmatogenous retinal detachment with proliferative vitreoretinopathy. Limited studies exist on long-term results of primary anterior segment removal of posterior IOFB combined with primary phacoemulsification. Methods: Medical records of consecutive patients who had ocular lacerations and posterior segment IOFB between October 2003 and June 2017 in a university hospital were reviewed. Patients who received a combined primary IOFB removal and phacoemulsification were included in the study. The postoperative evolution including visual acuity and complications were all recorded. Results: Thirteen patients (13 eyes) were included in the study. All patients were men, and the average age at presentation was 38 years. All IOFB were metallic, and their size ranged from 2 to 7 mm. All patients were operated within 24 hours of presentation. Six (46%) of the 13 lacerations were corneal, and 7 (54%) were scleral. Overall, 9 of 13 (69%) had a final postoperative best-corrected visual acuity equal to or better than 20 of 25. There were 3 (23%) postoperative complications of recurrent rhegmatogenous retinal detachment that occurred within the first postoperative year. Conclusion: Primary combined PPV and phacoemulsification with the removal of IOFB via the anterior segment is a safe and promising approach for repairing open globe injuries. Our results demonstrate the favorable prognostic benefit of this technique, which is recommended in cases with small corneal laceration and posterior segment pathology resulting from IOFB.

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