scholarly journals Characterization of an anterior segment organ culture model for open globe injuries

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eric J. Snider ◽  
Emily N. Boice ◽  
Brandon Gross ◽  
Jacinque J. Butler ◽  
David O. Zamora
Keyword(s):  
Intraocular Pressure ◽  
Organ Culture ◽  
High Speed ◽  
Anterior Segment ◽  
Tissue Adhesive ◽  
Open Globe Injury ◽  
Current Standard ◽  
Post Injury ◽  
Open Globe ◽  
Open Globe Injuries

AbstractOpen-globe injuries have poor visual outcomes and have increased in frequency. The current standard of care is inadequate, and a therapeutic is needed to stabilize the injury until an ophthalmic specialist is reached. Unfortunately, current models or test platforms for open-globe injuries are insufficient. Here, we develop and characterize an open-globe injury model using an anterior segment organ-culture platform that allows therapeutic assessment for up to 72 h post-injury. Anterior segments maintained in organ culture were kept at physiological intraocular pressure throughout, and puncture injuries were created using a novel pneumatic-powered system. This system can create high-speed, military-relevant injuries up to 4.5 mm in diameter through the cornea. From intraocular pressure readings, we confirmed a loss of pressure across the 72 h after open-globe injury. Proof-of-concept studies with a Dermabond tissue adhesive were performed to show how this model system could track therapeutic performance for 72 h. Overall, the organ-culture platform was found to be a suitable next step towards modeling open-globe injuries and assessing wound closure over the critical 72 h post-injury. With improved models such as this, novel biomaterial therapeutics development can be accelerated, improving care, and, thus, improving the prognosis for the patients.

Assessment of Commercial Off-the-Shelf Tissue Adhesives for Sealing Military-Relevant Corneal Perforation Injuries

2021 ◽  
Author(s):  
Eric J Snider ◽  
Lauren E Cornell ◽  
Brandon M Gross ◽  
David O Zamora ◽  
Emily N Boice
Keyword(s):  
Intraocular Pressure ◽  
High Speed ◽  
Anterior Segment ◽  
Ocular Tissue ◽  
Corneal Tissue ◽  
Corneal Perforation ◽  
Tissue Adhesives ◽  
Open Globe ◽  
Wide Range ◽  
Commercial Off The Shelf

ABSTRACT Introduction Open-globe ocular injuries have increased in frequency in recent combat operations due to increased use of explosive weaponry. Unfortunately, open-globe injuries have one of the worst visual outcomes for the injured warfighter, often resulting in permanent loss of vision. To improve visual recovery, injuries need to be stabilized quickly following trauma, in order to restore intraocular pressure and create a watertight seal. Here, we assess four off-the-shelf (OTS), commercially available tissue adhesives for their ability to seal military-relevant corneal perforation injuries (CPIs). Materials and Methods Adhesives were assessed using an anterior segment inflation platform and a previously developed high-speed benchtop corneal puncture model, to create injuries in porcine eyes. After injury, adhesives were applied and injury stabilization was assessed by measuring outflow rate, ocular compliance, and burst pressure, followed by histological analysis. Results Tegaderm dressings and Dermabond skin adhesive most successfully sealed injuries in preliminary testing. Across a range of injury sizes and shapes, Tegaderm performed well in smaller injury sizes, less than 2 mm in diameter, but inadequately sealed large or complex injuries. Dermabond created a watertight seal capable of maintaining ocular tissue at physiological intraocular pressure for almost all injury shapes and sizes. However, application of the adhesive was inconsistent. Histologically, after removal of the Dermabond skin adhesive, the corneal epithelium was removed and oftentimes the epithelium surface penetrated into the wound and was adhered to inner stromal tissue. Conclusions Dermabond can stabilize a wide range of CPIs; however, application is variable, which may adversely impact the corneal tissue. Without addressing these limitations, no OTS adhesive tested herein can be directly translated to CPIs. This highlights the need for development of a biomaterial product to stabilize these injuries without causing ocular damage upon removal, thus improving the poor vision prognosis for the injured warfighter.

scholarly journals Microbial contamination in open globe injury

1970 ◽  
Vol 4 (1) ◽  
pp. 84-89 ◽  
Author(s):  
S Bhala ◽  
S Narang ◽  
S Sood ◽  
C Mithal ◽  
AK Arya ◽  
...  
Keyword(s):  
Visual Outcome ◽  
Bacillus Species ◽  
Open Globe Injury ◽  
Open Globe ◽  
A Prospective Study ◽  
Culture Positive ◽  
Initial Contamination ◽  
Final Visual Outcome ◽  
Open Globe Injuries

Introduction: Endophthalmitis is the most dreaded complication of ocular trauma and knowledge of the microbial contaminants is essential to start empirical antibiotic therapy. Purpose: To determine incidence of contamination after open globe injuries (OGI) in our setup and to identify the spectrum of microorganisms contaminating open globe injuries. Material and methods: A prospective study including 50 consecutive eyes of open globe injury over a period of two years was conducted. Intra-operatively, 4 - 5 samples were taken from the inferior conjunctival sac and anterior chamber at the beginning and end of the open globe injury repair. Any abscised tissue or foreign body was also sent for culture sensitivity. A vitreous tap was taken from eyes with posterior segment trauma with signs of endophthalmitis. Results: Microbial cultures were positive in13 eyes (26 %). The microbial spectrum included Aspergillus species in 45.6 %, Alternaria in 15.2 %, Curvularia in 15.2 %, Staphylococcus aureus in 7.6 %, Bacillus species in 7.6 %, and Streptococcus pneumoniae in 7.6 %. Of these 13 eyes, nine eyes developed clinically evident frank endophthalmitis during follow-up. Overall, endophthalmitis developed in 20 eyes (40 %). There was a significant association between the initial contamination and development of endophthalmitis (p < 0.05). 53 % of culture positive cases achieved ambulatory vision compared to 73 % of culturenegative cases. Conclusion: Initial contamination was seen in 26 % of OGI cases. Aspergillus (fungus) was the commonest contaminant. There was a strong correlation between the initial contamination and development of endophthalmitis. Culture-negative cases had a trend towards better final visual outcome than culture-positive cases. Close follow up of cases showing contamination following OGI is recommended. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5857 NEPJOPH 2012; 4(1): 84-89

scholarly journals A Possible Regression Equation for Predicting Visual Outcomes after Surgical Repair of Open Globe Injuries

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Huseyin Gursoy ◽  
Mustafa Deger Bilgec ◽  
Afsun Sahin ◽  
Ertugrul Colak
Keyword(s):  
Primary Repair ◽  
Linear Regression Analysis ◽  
Anterior Segment ◽  
Penetrating Injury ◽  
Time Interval ◽  
Visual Outcomes ◽  
Primary Surgery ◽  
Open Globe ◽  
Trauma Score ◽  
Open Globe Injuries

Background. To analyze the effects of factors other than the ocular trauma score parameters on visual outcomes in open globe injuries.Methods. Open globe injuries primarily repaired in our hospital were reviewed. The number of surgeries, performance of pars plana vitrectomy (PPV), lens status, affected tissues (corneal, scleral, or corneoscleral), intravitreal hemorrhage, intraocular foreign body, glaucoma, anterior segment inflammation, loss of iris tissue, cutting of any prolapsed vitreous in the primary surgery, penetrating injury, and the time interval between the trauma and repair were the thirteen variables evaluated using linear regression analysis.Results. In total, 131 eyes with a mean follow-up of16.1±4.7(12–36) months and a mean age of33.8±22.2(4–88) years were included. The regression coefficients were 0.502, 0.960, 0.831, −0.385, and −0.506 for the performance of PPV, aphakia after the initial trauma, loss of iris tissue, penetrating injury, and cutting of any prolapsed vitreous in the primary surgery, respectively (P<0.05for these variables).Conclusions. The performance of PPV, aphakia after the initial trauma, and loss of iris tissue were associated with poor visual outcomes, whereas cutting any prolapsed vitreous in the primary repair and penetrating-type injury were associated with better visual outcomes.

scholarly journals Complete Visual Rehabilitation in a Patient with No Light Perception after Surgical Management of a Penetrating Open-Globe Injury: A Case Report

2015 ◽  
Vol 6 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Tania A. Baban ◽  
Fady K. Sammouh ◽  
Haytham M. El Ballouz ◽  
Elias L. Warrak
Keyword(s):  
Decision Making ◽  
Case Report ◽  
Poor Prognosis ◽  
Ocular Trauma ◽  
Light Perception ◽  
Patient Counseling ◽  
Open Globe Injury ◽  
Visual Rehabilitation ◽  
Open Globe ◽  
Open Globe Injuries

Open-globe injuries with no light perception (NLP) carry a poor prognosis, and many ophthalmologists select a primary enucleation or evisceration as a result. We present a case of complete visual rehabilitation in a patient who presented with NLP after a zone III penetrating open-globe injury. We recommend patient counseling regarding decision making and management of ocular trauma with NLP, since timely intervention and close follow-ups may restore useful or complete vision even in severely traumatized eyes.

scholarly journals Clinical Characteristics, Visual Outcomes, and Prognostic Factors of Open Globe Injuries

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1198
Author(s):  
Edita Puodžiuvienė ◽  
Gabrielė Valeišaitė ◽  
Reda Žemaitienė
Keyword(s):  
Prognostic Factors ◽  
Visual Impairment ◽  
Univariate Analysis ◽  
Vitreous Hemorrhage ◽  
Open Globe Injury ◽  
Visual Outcomes ◽  
Eye Trauma ◽  
Open Globe ◽  
Vitreous Prolapse ◽  
Open Globe Injuries

Background and Objectives: Open globe injuries (OGI) remain an important cause of visual impairment and loss, impacting all ages. A better understanding of the factors influencing visual outcomes is important in an attempt to improve the results of the treatment of OGI patients. The author aimed to contribute to this knowledge with the analysis of clinical characteristics, prognostic factors, and visual outcomes of their cohort of OGI patients. Materials and Methods: A retrospective medical record review was performed for 160 patients (161 eyes) who sustained an open globe injury between January 2015 and December 2017 and presented to the Hospital of Lithuanian University of Health Sciences. Data analyzed included age, sex, type, cause, place of OGI, initial visual acuity (VA), final best-corrected visual acuity (BCVA), and tissue involvement. Open globe injuries were classified using the Birmingham Eye Trauma Terminology (BETT) and Ocular Trauma Classification System (OTCS). Univariate analysis was conducted to evaluate the prognostic factors. Results: The mean age of the patients was 41.9 years. The male-to-female ratio was found to be 8.4:1. The home was the leading place of eye injury (59.6%), followed by an outdoor environment (14.3%) and workplace (11.8%). Penetrating injury accounted for 43.5%, followed by intraocular foreign body injury (39.1%) and globe rupture (13%). Overall, 19.5% of patients regained a good final vision of ≥0.5, but for 48.1% of them, eye trauma resulted in severe visual impairment (BCVA ≤ 0.02). In the univariate analysis, a bad visual outcome of less than 0.02 was correlated with bad initial VA, iris dialysis, hypotony, vitreous hemorrhage, and vitreous prolapse at presentation. Phthisis bulbi was correlated with eyelid laceration, iris prolapse, iris dialysis, hyphema, vitreous prolapse, vitreous hemorrhage, and choroidal rupture at initial examination. Conclusions: Open globe injury remains an important preventable cause of ocular morbidity. This study provides data indicating that open globe injuries are a significant cause of visual impairment in our research group.

Sign in / Sign up

Export Citation Format

Share Document