Abstract
Background: Ocular trauma has relationship with variable damage towards anterior segment or posterior segment. Among them, cornea, iris and lens are vulnerable to injury. For patients with traumatic cataract and other anterior segment trauma， complete reconstruction of anterior segment surgery can be a good option to restore patients’ anterior segment that helps them regain their vision.
Case presentation: We presented a case of traumatic cataract with iris defects after explosive trauma. A surgery was done to fully reconstruct the anterior segment of the patient’s left eye including separating posterior synechia of iris, removing cataract and implantation of IOL. Postoperatively, the patient didn’t complain about photophobia anymore and the uncorrected visual acuity (UCVA) of the patient reached from counting fingers to 20/25 and remained stable on follow-up at 1 week and 1 month.
Conclusion: Our case suggested the importance of completely reconstruct anterior segment for patients who have traumatic cataract with traumatic iris defects and its benefits for society.
Keywords: Traumatic cataract; Traumatic iris defect; Surgery
Introduction. Urrets-Zavalia syndrome (UZS) has been defined as a fixed and dilated pupil accompanied by iris atrophy and occasionally secondary glaucoma. The precise cause of the syndrome is uncertain. Most often it has been described following anterior segment surgery. The objective of this article is to present how to successfully handle patients with UZS after posterior segment surgery. We present all the dilemmas and difficulties we encountered during the diagnostic process. Case outline. This is a case presentation of a patient with UZS following scleral buckle procedure. To our knowledge, this is the first case of UZS following this type of posterior segment surgery. The delay in treatment was mostly due to the lack of knowledge about the linkage of this syndrome with posterior segment surgery. Once the diagnosis was confirmed, parasympathomimetic drops were administered. The patient responded well to the therapy and partial reduction of mydriasis and restoration of pupillary kinetics was observed. Conclusion. Two months after surgery, the treatment of UZS resulted in slight residual anisocoria with signs of iris atrophy. This could indicate reversible mechanism of UZS after posterior segment surgery with iris atrophy as the only permanent consequence.
Purpose. To study the ocular manifestations in patients with pseudophakia who underwent COVID-19 during the rehabilitation period after surgery. Material and methods. 46 patients with Phaco with implantation of IOL who underwent COVID-19 in the period from 1 week to 2 months after surgery. Of the examined patients, there were 28 men (61%), 18 women (391%). The average age of the patients was 63±1,2 years. Results. In 78% of cases, vascular pathology of the anterior and posterior segments of the eyeball was observed in patients who underwent COVID-19 in the early postoperative period after Phaco with implantation of IOL. Conclusions. The main ocular symptoms from the anterior segment of the eyeball in patients in 17% of cases were the occurrence or intensification of previously existing manifestations of the «dry eye» syndrome, as well as inflammatory phenomena from the anterior part of the uveal tract. From the posterior segment of the eye, in 70% of cases, there was a progression of vascular disorders, as well as the appearance of complications associated with manifestations of hypercoagulation syndrome and systemic vasculopathy. Key words: Covid-19, cataract phacoemulsification, pseudophakia.
Some form of ophthalmic injury is seen in the majority of lightening victims. These may be anterior segment involvement, mostly the cornea. Other lesion on the anterior segment include uveitis, hyphaema, cataract and dislocated lens. Posterior segment lesion include vitreous haemorrhage, retinal oedema, retinal haemorrhage, retinal detachment, cystoids macular oedema, chorioretinalrupture, maculopathy, CRVO and CRAO. Neuro-ophthalmic lesion include loss of pupillaryreflex, anisocoria, horner syndrome, multiple cranial nerve palsies and nystagmus.
Purpose: To report two cases; bilateral arteritic anterior ischemic optic neuropathy (AAION) and bilateral acute zonal occult outer retinopathy (AZOOR) after COVID-19 mRNA vaccination.
Case Reports: The first patient was a 79-year-old female was presented to us 35 days after a sudden bilateral loss of vision, which occurred two days after receiving the second recombinant mRNA vaccine (Pfizer) injection. Temporal artery biopsy was compatible with AAION. At presentation, the best-corrected visual acuity was 20/1250 and 20/40 in the right and left eyes on the Snellen acuity chart, respectively. There was 3+ afferent pupillary defect in the right eye. The anterior segment and posterior segment exams were normal except for pallor of the optic nerve head in both eyes. Intraocular pressure was normal in both eyes. She was diagnosed with bilateral AAION and Subcutaneous tocilizumab 162 mg weekly was recommended with monitoring her ESR, CRP, and IL-6. The second patient was a 33-year-old healthy female who was referred to us for a progressive nasal field defect in her left eye, and for flashes in both eyes. Her symptoms started 10 days after receiving the second recombinant mRNA vaccine (Moderna) injection. Complete bloodwork performed by a uveitis specialist demonstrated high ESR (25) and CRP (19) levels. As a result, she was diagnosed with unilateral AZOOR in her left eye and was subsequently treated with an intravitreal dexamethasone implant in the same eye. At presentation, vision was20/20 in both eyes. The anterior segment and posterior segment exams were completely normal except for the presence of abnormal white reflex in the temporal macula of her left eye. We diagnosed her with bilateral AZOOR. Since she was nursing, intravitreal dexamethasone implant was recommended for the right eye.
Conclusion: There may be a correlation between ocular inflammatory diseases with autoimmune mechanism and the mRNA COVID-19 vaccination.
Complete reconstruction of anterior segment surgery for a patient with traumatic cataract and iris defects: a case report
