scholarly journals Successful Management in a Case of Traumatic Retinal Detachment due to Open Globe Injury Using Microincisional Vitrectomy

2016 ◽  
Vol 7 (3) ◽  
pp. 476-480 ◽  
Author(s):  
Wei-Yu Lai ◽  
Tsung-Tien Wu
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Medical Center ◽  
Primary Repair ◽  
Surgical Techniques ◽  
Open Globe Injury ◽  
Open Globe ◽  
Silicone Oil Tamponade

Background: Retinal detachment (RD) following ocular trauma often results in guarded visual prognosis and sometimes leads to loss of the eye. With the advent of microincisional vitrectomy surgery and the development of surgical techniques, the management of ocular trauma has been transformed. Case Presentation: A 34-year-old man sustained an open globe injury from fragmented glass at work. He received primary repair and another follow-up surgery 9 days later, including vitrectomy, silicone oil tamponade, and lensectomy for RD and traumatic cataract at another medical center. However, his retina was totally detached and completely curled up in a roll with choroid on display when he was seen by us 1 month later. He was managed with vigilant and patient peeling and unfolding of the retina using a 23-gauge forceps and silicone oil tamponade, and achieved anatomical success and preservation of his eye at 6-month follow-up. Conclusions: This report demonstrates that even in cases which appear to be hopeless at presentation, the surgeon’s perseverance and surgical technique can salvage an eye that may otherwise be phthisical. It also encourages retinal surgeons to use microincisional vitrectomy to manage severe traumatic RD.

Limitation of computed tomography scan in ocular trauma in diagnosing posterior globe rupture and retinal detachment

Trauma ◽  
2016 ◽  
Vol 20 (1) ◽  
pp. 72-76
Author(s):  
AR Munirah ◽  
MK Safinaz ◽  
ZMZ Aida ◽  
A Malisa ◽  
MI Hazlita
Keyword(s):  
Computed Tomography ◽  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Primary Repair ◽  
Computed Tomography Scan ◽  
Penetrating Eye Injury ◽  
Globe Rupture ◽  
Open Globe ◽  
Tomography Scan

Ocular trauma with penetrating eye injury or globe rupture is an ophthalmic emergency. Immediate but gentle ocular assessment is mandatory to diagnose the extent of the injury. Imaging modalities are valuable in aiding diagnosis and management in open globe injury due to the difficulty of full eye assessment in the presence of multiple head and facial injuries. This report presents a case of an elderly man with ocular trauma of the left only seeing eye where computed tomography scan showed anterior globe rupture and the possibility of posterior globe rupture due to discontinuity of the posterior sclera. Primary repair and exploration of the left eye revealed no posterior globe rupture. Post-operative B-scan revealed a total retinal detachment with intact posterior globe. Vision of the left eye after pars planar vitrectomy and tamponade of the retina detachment with heavy silicone oil improved to 1/60. Computed tomography scan in ocular trauma has limitations especially in diagnosing retinal detachment and posterior globe rupture.

scholarly journals Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries

2022 ◽  
Vol 8 ◽  
Author(s):  
Huijin Chen ◽  
Jiarui Yang ◽  
Changguan Wang ◽  
Xuefeng Feng ◽  
Kang Feng ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Open Globe Injury ◽  
Oil Migration ◽  
Corrected Visual Acuity ◽  
Open Globe ◽  
Baseline Information ◽  
Suturing Methods

PurposeTo explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion.DesignProspective cohort, hospital-based study.MethodsA total of 24 patients who were diagnosed with choroidal avulsion were enrolled in this study. The demographic characteristics, baseline information of trauma, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected before surgery, and the anatomic abnormities of the globe were recorded before or during surgery. All patients were diagnosed with choroidal avulsion and underwent choroid suturing treatment during vitrectomy, postoperative functional variables including BCVA and IOP, anatomic variables including retinal and choroidal reattachment rate, and silicone oil migration rate, which were recorded at the regular follow-ups at least 1 year after surgery.ResultsAll patients with open globe injury involved zone III, 70.8% of the patients presented with two quadrants of the avulsed choroid, and 29.2% with one quadrant involved; moreover, all patients had complications with retinal detachment (RD), of which 58.3% of patients had closed funnel retinal detachment. TSS was applied in nineteen patients and IOS in five patients. Postoperatively, a significant improvement on LogMAR BCVA was observed at each follow-up from 3.57 ± 0.69 before surgery to 2.82 ± 0.98 at the last follow-up (p < 0.05), and the proportion of no light perception (NLP) was also reduced from 69.6 to 37.5%. IOP was markedly elevated from 6.4 ± 4.1 mmHg preoperatively to 11.3 ± 4.3 mmHg at the last follow-up (p < 0.05). Choroidal reattachment was achieved in 91.7% of patients; two patients were observed with silicone oil migration at 3 months after surgery and underwent drainage of suprachoroidal silicone oil and sclera buckling. Meanwhile, retinal attachment was observed in 95.8% of patients, only one patient developed partial RD due to postoperative proliferative vitreoretinopathy, and secondary vitrectomy was performed; all patients were observed with complete retinal and choroidal attachment at the last follow-up. Eventually, four patients were silicone oil-free, and 20 patients were silicone oil-dependent.ConclusionsChoroidal suturing proved to be an effective method to fix the avulsed choroid, which greatly improved the BCVA and maintained the IOP, and efficiently increased the choroidal and retinal reattachment rate and preservation of the eyeball.

scholarly journals Reliability of the ocular trauma score for the predictability of traumatic and post-traumatic retinal detachment after open globe injury

2021 ◽  
Vol 14 (10) ◽  
pp. 1589-1594
Author(s):  
Simon Dulz ◽  
◽  
Toam Katz ◽  
Robert Kromer ◽  
Eileen Bigdon ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Vitreous Hemorrhage ◽  
Open Globe Injury ◽  
Ocular Trauma Score ◽  
Open Globe ◽  
Significant Difference ◽  
Post Traumatic ◽  
Trauma Score

AIM: To elucidate the question of whether the ocular trauma score (OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment (RD) in patients with open globe injury (OGI). METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12mo follow-up and a median age at of 48.6y (range: 3-104y) were identified. Final best corrected visual acuity (BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score I (P<0.0001) or II (P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >III. OGI associated RD was observed in 36/102 patients (35.3%), whereas post traumatic RD (defined as RD following 14d after OGI) occurred in 37 patients (36.3%). OGI associated RD did not correlate with the OTS and the zone of injury (P=0.193), yet post traumatic RD correlated significantly with zone III injuries (P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone III injury with lower final BCVA and a higher number of surgeries, but only zone III could be significantly associated with a higher rate of RD.

scholarly journals Hyphema in Open-Globe Versus Closed-Globe Injuries in Operation Iraqi Freedom and Enduring Freedom: 2001–2011

2019 ◽  
Vol 185 (5-6) ◽  
pp. e768-e773 ◽  
Author(s):  
Natalie R Miller ◽  
Grant A Justin ◽  
Won I Kim ◽  
Daniel I Brooks ◽  
Denise S Ryan ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Medical Center ◽  
Visual Outcome ◽  
Walter Reed Army Medical ◽  
Cataract Formation ◽  
Traumatic Cataract ◽  
Open Globe ◽  
Ocular Injuries ◽  
Iraqi Freedom

Abstract Introduction The goal of this study is to update the incidence of hyphema in Operation Iraqi (OIF) and Enduring Freedom (OEF). We wanted to assess associated ocular injuries and final visual acuity (VA) in open-globe versus closed-globe injuries with a hyphema. Materials and Methods We performed a retrospective review of the Walter Reed Ocular Trauma Database (WRTOD) to identify U.S. Service members and DoD civilians with hyphema who were evacuated to Walter Reed Army Medical Center between 2001 and 2011. Primary outcome measures were the final VA and differences in concomitant ocular injuries in open-globe hyphema and closed-globe hyphema. Results 168 of 890 eyes (18.9%) in the WROTD had a hyphema. Closed-globe injuries were noted in 64 (38.1%) eyes and open-globe injuries in 104 (61.9%) eyes. A final VA of less than 20/200 was noted in 88 eyes (51.8%). Eyes with hyphema were more likely to have traumatic cataract formation (odds ratio (OR) 6.2, 95% confidence interval (CI) 4.2–9.2, P &lt; 0.001), retinal detachment (OR 4.2, CI 2.8–6.4, P &lt; 0.001), angle recession (OR 8.1, CI 2.9–24.3, P &lt; 0.001), and final VA of less than 20/200 (OR 3.7, CI 2.6–5.4, P &lt; 0.001). Traumatic cataract formation (OR 7.4, CI 2.9–18.7, P &lt; 0.001), retinal detachment (OR 6.1, CI 2.1–17.5, P &lt; 0.001), and a final VA less than 20/200 (OR 6.1, CI 2.4–15.4 P &lt; 0.001) were statistically more likely to occur with an open-globe hyphema than with a closed-globe hyphema. Conclusions Close follow-up in patients with hyphema is important due to the associated development of traumatic cataract and retinal detachment and poor final visual outcome.

Pediatric open-globe injury in a university-based tertiary hospital

2018 ◽  
Vol 30 (2) ◽  
pp. 269-274 ◽  
Author(s):  
Faisal AlDahash ◽  
Ahmed Mousa ◽  
Priscilla W Gikandi ◽  
Ahmed M Abu El-Asrar
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Visual Outcome ◽  
Tertiary Hospital ◽  
Open Globe Injury ◽  
Female Ratio ◽  
Initial Visual Acuity ◽  
Open Globe ◽  
Type Of Injury

Background: To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. Methods: We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. Results: A total of 213 patients were identified. Male–female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. Conclusions: The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.

scholarly journals Study on the effectiveness and safety of Foldable Capsular Vitreous Body implantation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiangyang Zhang ◽  
Xuemin Tian ◽  
Baike Zhang ◽  
Lisa Guo ◽  
Xiaodan Li ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Vitreous Body ◽  
Fundus Photography ◽  
Specular Microscopy ◽  
Applanation Tonometer ◽  
Before And After ◽  
Fellow Eyes

Abstract Background Foldable capsular vitreous body (FCVB) was designed to treat severe retinal detachment. The aim of this study was to evaluate the efficacy and safety of the implantation of foldable capsular vitreous body in 1-year follow-up. Methods A retrospective analysis was conducted for 20 patients with severe ocular trauma or silicone oil (SO) dependent eyes underwent vitrectomy and FCVB implantation in a 1-year follow-up. All treated eyes were peformed clinical examinations involved the visual acuity (VA) examination, Goldmann applanation tonometer, noncontact specular microscopy, fundus photography, B-Scan examination and optical coherence tomography (OCT). The groups were compared with t-test and the McNemar - Bowker test. Results In 1-year follow-up, 20 eyes were evaluated in the study. FCVB well supported the vitreous retina in all treated eyes, and 6 treated eyes achieved retinal reattachment 12 months after FCVB implantation. There were no significant differences in VA before and after FCVB implantation (P = 1.000). In addition, the postoperative IOP markedly elevated from the preoperative IOP of 12.90 ± 7.06 mmHg to 15.15 ± 3.36 mmHg (P = 0.000017). The intraocular pressure (IOP) of 10 eyes maintained at a normal level after surgeries. The other 10 eyes showed slightly lower IOP within the acceptable level. Though two patients developed keratopathy and ocular inflammation respectively, other treated eyes were symmetric with fellow eyes showing satisfactory appearance. Moreover, there was no SO emulsification or leakage happened in the observation. Conclusions FCVB implantation was an effective and safe treatment in the eyes with severe retinal detachment.

Follow-up of functionally lost eyes after vitrectomy and silicone oil tamponade for tractional retinal detachment

1999 ◽  
Vol 237 (9) ◽  
pp. 741-744 ◽  
Author(s):  
Janine van den Brink ◽  
O. Weijtens ◽  
Eric J. Feron ◽  
Paul Mulder ◽  
Diane A. E. Mertens ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Tractional Retinal Detachment ◽  
Silicone Oil Tamponade
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