Visual acuity recovery due to anterior segment reconstruction after severe bilateral open globe injury – case report

Introduction. Reduced corneal transparency leads to dissipation of energy of the femtosecond laser (FSL), which may complicate the formation of the intrastromal incision and limits the use of FSL in eyes with corneal opacities and scars. The purpose of this work is to demonstrate the possibility of successful ReLEx SMILE in a patient with superficial corneal opacity located in the paracentral zone. Case report. Patient R., 29 years old, complained of decreased vision in both eyes since childhood. Visual acuity OD = 0.1 sph –2.75D = 1.0; OS = 0.1 sph –3.50 D cyl –0.75D ax 165° = 1.0. Biomicroscopy of the right eye visualized a superficial semi-transparent corneal opacity of 5 x 3 mm located at 5.30–6 hours at a distance of 1.3 mm from the optical center. According to the anterior segment optical coherence tomography (AS-OCT) the depth of the opacity was 73–78 microns and was limited by the Bowman’s membrane. ReLEx SMILE for myopia correction was performed on both eyes with 6.7 mm lenticule diameter at a depth of 120 µm, which covered the opacity area by 1.1 mm. The surgery was standard and uncomplicated. Seven days postoperatively the patient did not complain. Uncorrected visual acuity (UCVA) was 1.0 for both eyes (and binocularly it was 1.2). According to the AS-OCT data, a hyperreflective line of the interface zone was visualized on the right eye at the depth of 141–147 µm; the opacified superficial corneal layers were detected in the lower paracental zone over the interface line. In one month after the surgery the visual acuity did not change: UCVA = 1.0 in both eyes (binocularly 1.2). Conclusion. ReLEx SMILE technology can be considered as one of the options for myopia correction in patients with superficial corneal opacity located in the paracental zone. More observations are required to evaluate the effectiveness of this technology on corneas with paracentral opacities different in sizes and located at different depths.

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Bungee cord related ocular trauma: An avoidable cause of ocular morbidity

Panacea Journal of Medical Sciences ◽

10.18231/j.pjms.2021.060 ◽

2021 ◽

Vol 11 (2) ◽

pp. 297-300

Author(s):

Nazia Imam ◽

Mobashir Sarfraz Ali ◽

Bibhuti Prassan Sinha ◽

Gyan Bhaskar ◽

Rakhi Kusumesh

Keyword(s):

Visual Acuity ◽

Clinical Features ◽

Medical Records ◽

Tertiary Care ◽

Final Visual Acuity ◽

Ocular Injury ◽

Age Group ◽

Mechanism Of Injury ◽

Open Globe Injury ◽

Open Globe

To study the mechanism and clinical features of ocular injury and its outcome associated with bungee cord related eye trauma. A retrospective review of medical records was performed at our tertiary care centre to identify patients presented with bungee cord related eye injury between March 2016 to February 2017. Data collected from medical records were age, sex, mechanism of injury, clinical features, therapeutic intervention, presenting visual acuity, final visual acuity and length of follow up. Total of thirteen patients with bungee cord related trauma were identified. Ten (77%) patients presented with closed globe injury and 3(23%) presented with open globe injury. All patients were male with mean age group of 30.15±7.38 years. Presenting visual acuity ranges from 6/12 to NPL. Only seven (54%) of patients were having final visual acuity of better than or equal to 6/18 in injured eye. Three patients (23.1%) with open globe injury had final visual acuity of counting fingers or worse. Main mechanism of injury being combination of blunt and high speed projectile injury due to slippage of metal or plastic hook while the cord is stretched. Trauma with bungee cord is usually affecting working age group male with injury resulting in loss of workable vision to loss of eye hence there is need of appropriate intervention like use of printed warning on package and modification of hook design to decrease the incidence of bungee cord related trauma.

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

European Journal of Ophthalmology ◽

10.1177/1120672118818013 ◽

2018 ◽

Vol 30 (2) ◽

pp. 269-274 ◽

Cited By ~ 2

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.

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

Case Reports in Ophthalmology ◽

10.1159/000434636 ◽

2015 ◽

Vol 6 (2) ◽

pp. 204-209 ◽

Cited By ~ 1

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.

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Ultrabiomicroscopy Anterior Segment Evaluation of Ocular Contusive Trauma Caused by Pressurized Bottled Drink Caps: A Case Report

Case Reports in Ophthalmology ◽

10.1159/000492107 ◽

2018 ◽

Vol 9 (2) ◽

pp. 365-368

Author(s):

Raffaele Antonio Esposito ◽

Alessandra Rosati ◽

Giuseppe Mannino ◽

Gianluca Scuderi

Keyword(s):

Emergency Department ◽

Visual Acuity ◽

Case Report ◽

Anterior Segment ◽

Endothelial Damage ◽

Sparkling Wine ◽

Descemet's Membrane ◽

Descemet’S Membrane ◽

Wine Bottle

We report the case of a patient presented to the emergency department because of a contusive trauma from a pressurized bottled drink cap. During the visit, the patient indicated that he had been hit in his left eye by a cork while he was opening a sparkling wine bottle. He underwent a total ophthalmology examination. He had an important reduction of visual acuity, corneal swelling, Descemet’s folds, and hyphema. Therefore, we decided to perform ultrabiomicroscopy (UBM) of the anterior segment to study the endothelial damage and Descemet’s membrane. UBM images confirmed the direct biomicroscopy, highlighting the damaged location.

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

Scientific Reports ◽

10.1038/s41598-021-87910-8 ◽

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.

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