Vitrectorhexis in penetrating eye injuries in adults

2018 ◽  
Vol 29 (6) ◽  
pp. 689-693
Author(s):  
Miklós D Resch ◽  
Anikó Balogh ◽  
Gábor L Sándor ◽  
Zsuzsanna Géhl ◽  
Zoltán Zsolt Nagy
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Posterior Chamber ◽  
Ocular Injury ◽  
Eye Injuries ◽  
Anterior Capsule ◽  
Safe Alternative ◽  
Anterior Lens Capsule ◽  
Pars Plana

Introduction: Vitrectorhexis is an alternative for manual continuous curvilinear capsulorhexis originally developed for paediatric cataract surgery. The aim of our study was the evaluation of the technique in adult patients with penetrating ocular injury and traumatic cataracts. Methods: Eight eyes of 8 patients (23–41 years, all males) had penetrating mechanical corneal trauma. Anterior lens capsule was penetrated in all cases and additional posterior capsule defect in five cases. Intraocular foreign body was detected in one case in the crystalline lens and in two cases in the posterior segment. Standard 23G infusion cannula and vitreous cutter were applied to perform anterior capsule opening, removal of lens material, anterior vitrectomy and pars plana vitrectomy if needed. No phacoemulsification or irrigation/aspiration probe was used. Results: Vitrectorhexis could be performed in 7 out of 8 cases with the preservation of peripheral anterior capsule; primary implantation of posterior chamber intraocular lens was possible in all cases (in the bag in three eyes and into the sulcus in five eyes). Anterior chamber was stable in all cases intraoperatively, and no dropped nucleus or lens fragment loss was observed. Surgery was combined with pars plana vitrectomy in three cases, with foreign body removal (when necessary). No postoperative complication occurred. Conclusion: Vitrectorhexis was found to be an effective and safe alternative method in the management of complex anterior segment trauma cases. With its use, traditional cataract surgical devices can be substituted and additional benefits of vitreous cutter can be utilized in selected cases, especially in young adults.

scholarly journals Lens-induced hypopyon uveitis as the presenting manifestation of posterior lens nucleus dislocation following pars-plana vitrectomy: case report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ksiaa Imen ◽  
Ben Hadj Tahar Meriam ◽  
Sellem Ilhem ◽  
Attia Sonia ◽  
Abroug Nesrine ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Oral Corticosteroid ◽  
Anterior Segment ◽  
Final Diagnosis ◽  
Anterior Capsule ◽  
Ocular Pressure ◽  
Pars Plana ◽  
Bullous Retinal Detachment ◽  
Lens Material

AbstractA 57-year-old otherwise healthy male presented to our department seven days following uneventful pars-plana vitrectomy with gas tamponade for a superior bullous retinal detachment in the left eye. Ophthalmic examination revealed anterior segment inflammation with hypopyon and fibrinous exudate. Intra-ocular pressure was 28 mmHg. Posterior segment evaluation was difficult to assess due to the presence of anterior capsule opacification and gas bubble. A Toxic Anterior Segment Syndrome was suspected, and the patient was treated with topical and oral corticosteroid medication in combination with anti-glaucomatous therapy. On follow-up, anterior segment inflammation and ocular hypertension improved. On day ten post-operatively, ocular ultrasonography demonstrated lens material inferiorly with attached retina. The final diagnosis of posterior lens nucleus dislocation with lens-induced uveitis was retained. The patient underwent an uneventful second vitrectomy with aspiration of the dislocated lens nucleus and sulcus three piece-lens implantation. On last follow-up, visual acuity was 20/50 with no relapsing of ocular inflammation and the retina remained reattached.

scholarly journals PosttraumaticSphingomonas paucimobilisEndophthalmitis

2015 ◽  
Vol 2015 ◽  
pp. 1-2
Author(s):  
Konstantinos Droutsas ◽  
Georgios Kalantzis ◽  
Chrysanthos Symeonidis ◽  
Ilias Georgalas
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Ocular Injury ◽  
Sphingomonas Paucimobilis ◽  
Eye Injury ◽  
Slit Lamp ◽  
Good Healing ◽  
Pars Plana ◽  
Retinal Complications

A rare case ofSphingomonas paucimobilisendophthalmitis secondary to a penetrating globe injury with a retained intraocular foreign body is presented. A 30-year-old man presented with severe pain following a penetrating left eye injury. Visual acuity (VA) was 6/120. Slit-lamp examination revealed perforation of the temporal cornea and iris, hypopyon, and a fibrinous membrane covering the pupil. Ultrasonography showed dense vitreous infiltration and an orbital CT-scan confirmed the presence of a metallic foreign body in the vitreous cavity. Topical and systemic therapy were initiated. Pars-plana vitrectomy combined with phacoemulsification was performed in order to remove the foreign body; vitreous samples were acquired andSphingomonas paucimobilis, sensitive to ceftazidime, was identified. To the best of our knowledge, this is the first report ofSphingomonas paucimobilisendophthalmitis following penetrating ocular injury. In this case,Sphingomonas paucimobiliswas not resistant to antibiotics. This allowed for a good healing response following vitrectomy despite the fact that long-term retinal complications resulted in low VA.

scholarly journals Perfluorocarbon liquid-assisted intraocular foreign body removal

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.

Phacoemulsification in vitrectomized eyes: Maintaining the stability of the anterior chamber via a new technique

2020 ◽  
pp. 112067212094019
Author(s):  
Xinxin Li ◽  
Qiumei Li ◽  
Shazia Bano ◽  
Shaowei Li
Keyword(s):  
Anterior Chamber ◽  
Pars Plana Vitrectomy ◽  
Intraoperative Complications ◽  
Anterior Chamber Depth ◽  
Posterior Chamber ◽  
Anterior Capsule ◽  
Pars Plana ◽  
Common Problems ◽  
A New Technique ◽  
The Stability

Fluctuating anterior chamber depth and reverse pupillary block are the most common problems encountered during phacoemulsification following pars plana vitrectomy in cases of cataracts. The sudden deepening of the anterior chamber makes the surgical procedure more cumbersome and increases the risk of intraoperative complications. To solve this problem, we describe a method of balancing the pressure of the anterior and posterior chamber by using a syringe with a flushing needle to inject balanced salt solution into the posterior chamber via the gap between the iris and the anterior capsule of the lens. This technique is especially suitable for complicated cataracts following previous pars plana vitrectomy and high myopia-complicated cataracts. This technique yielded promising results in reducing the difficulties that occur during surgical procedures, reduced the risk of intraoperative complications and simplified the intraocular lens implantation.

scholarly journals Post-traumatic endophthalmitis with retained intraocular foreign body – a case report with review of literature

1970 ◽  
Vol 4 (1) ◽  
pp. 187-190 ◽  
Author(s):  
P Aggarwal ◽  
P Garg ◽  
HK Sidhu ◽  
S Mehta
Keyword(s):  
Foreign Body ◽  
Iron Particle ◽  
Posterior Chamber ◽  
Causative Organism ◽  
Eye Drops ◽  
Eye Injuries ◽  
Anterior Lens Capsule ◽  
Vitreous Opacities ◽  
Post Traumatic ◽  
The Right

Introduction: Endophthalmitis following penetrating eye injuries has a poor prognosis and presents a diagnostic and therapeutic challenge. The aim of reporting this case was to identify the causative organism of post-traumatic endophthalmitis due to retained iron foreign body and to highlight the importance of carrying out diagnostic investigations. Case: A 20-year-old male presented with tenderness and blurring in the right eye 3 days after injury with an iron particle. Visual acuity was perception of light with accurate projection of rays in all quadrants. The slit-lamp examination revealed ciliary and conjuctival congestion. There was a verticallyoriented self-sealed, full-thickness laceration in the cornea adjacent to the limbus. The anterior chamber evaluation revealed + 4 cells, +3 flare and a 2 - mm hypopyon. There was cataract with a ruptured anterior lens capsule. Posterior synechae was present at 5’0 clock position. B-scan showed echogenic metallic foreign body in the posterior chamber, with vitreous opacities. The vitreous tap was done and intra-vitreal antibiotics injections of 1 mg in 0.1 ml vancomycin and 2.25 mg in 0.1 ml ceftazidime were given. Culture and sensitivity of the tap revealed staphylococcus as the causative agent. The patient was put on moxifloxacin eye drops, fortified tobramycin and cephazolin eye drops 1 hourly along with atropine eye drops. The patient was referred to the vitreoretinal surgeon urgently for pars plana vitrectomy and foreign body removal. At follow up, the patient’s BCVA was improved. Conclusion: The causative organism isolated was similar to that documented in other reports. Endophthalmitis must be treated with vitrectomy and intra-vitreal injections of antibiotics after a proper vitreous tap. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5875 NEPJOPH 2012; 4(1): 187-190

scholarly journals Lens-induced hypopyon uveitis as the presenting manifestation of posterior lens nucleus dislocation following pars-plana vitrectomy: case report

2021 ◽  
Author(s):  
Imen Ksiaa ◽  
Meriam Ben Hadj Tahar ◽  
Ilhem Sellem ◽  
Sonia Attia ◽  
Nesrine Abroug ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Anterior Segment ◽  
Final Diagnosis ◽  
Oral Steroid ◽  
Anterior Capsule ◽  
Ocular Pressure ◽  
Pars Plana ◽  
Bullous Retinal Detachment ◽  
Lens Material

Abstract A 57-year-old otherwise healthy male presented to our department seven days following uneventful pars-plana vitrectomy with gas tamponade for a superior bullous retinal detachment in the left eye. Ophthalmic examination revealed anterior segment inflammation with hypopyon and fibrinous exudate. Intra-ocular pressure was 28 mm Hg. Posterior segment evaluation was difficult to assess due to the presence of anterior capsule opacification and gas bubble. A Toxic Anterior Segment Syndrome was suspected and the patient was treated with topical and oral steroid medication associated with anti-glaucomatous therapy. On follow-up, anterior segment inflammation and ocular hypertension improved. On day ten post-operatively, ocular ultrasonography demonstrated lens material inferiorly with attached retina. The final diagnosis of posterior lens nucleus dislocation with lens-material antigenic uveitis was retained. The patient underwent an uneventful second vitrectomy with aspiration of the dislocated lens nucleus and sulcus three piece-lens implantation. On last follow-up, visual acuity was 20/50 with no relapsing of ocular inflammation and the retina remained reattached.

Pars Plana Vitrectomy in Ocular Injury with Intraocular Foreign Body

2005 ◽  
pp. 1216-1218 ◽  
Author(s):  
Nihal Demircan ◽  
Merih Soylu ◽  
Meltem Yagmur ◽  
Handan Akkaya ◽  
Altan Atakan Ozcan ◽  
...  
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Intraocular Foreign Body ◽  
Ocular Injury ◽  
Pars Plana

Transscleral Extraction of an Intraocular Foreign Body From the Posterior Segment of the Eye Without Pars Plana Vitrectomy

2020 ◽  
Vol 76 (1) ◽  
pp. 14-23
Author(s):  
Štěpán Rusňák ◽  
Lenka Hecová
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Young Patients ◽  
Vitreous Body ◽  
Visual Control ◽  
Intraocular Foreign Body ◽  
Survey Study ◽  
Surgical Method ◽  
Eye Trauma ◽  
Pars Plana

Purpose: Penetrating eye trauma with an intraocular foreign body is very frequent, especially in men in their productive age. Pars plana vitrectomy would be the standard surgical method at our department. However, in indicated cases (metallic intraocular bodies in the posterior eye segment in young patients with well transparent ocular media without detached ZSM and without any evident vitreoretinal traction) transscleral extraction of the intraocular foreign body is performed using the exo magnet, eventually endo magnet with a minimal PPV without PVD induction under the visual control of endo-illumination. Materials and Methods: Between June 2003 and June 2018, 66 eyes of 66 patients diagnosed with a penetrating eye trauma caused by an intraocular foreign body located in the posterior eye segment were treated. In 18 eyes (27,3 %) with a metallic foreign body in vitreous (body) or in retina, no PPV or a minimal PPV without PVD was used as a surgical method. In the remaining 48 eyes (72,7 %), a standard 20G, respectively 23G PPV method were used together with PVD induction and the foreign body extraction via endo or exo magnet. Conclusions: As demonstrated by our survey/study, in the cases of a thoroughly considered indication an experimented vitreoretinal surgeon can perform a safe NCT transscleral extraction from the posterior eye segment via exo magnet, eventually endo magnet under the visual control of a contact display system with a minimal PPV. Thereby, the surgeon can enhance the patient´s chance to preserve their own lens and its accommodative abilities as well as reduce the risk of further surgical interventions of the afflicted eye.

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