scholarly journals Complete reconstruction of anterior segment surgery for a patient with traumatic cataract and iris defects: a case report

2019 ◽  
Author(s):  
Zhenyu Wang ◽  
Xuemin Li
Keyword(s):  
Ocular Trauma ◽  
Anterior Segment ◽  
Posterior Segment ◽  
Traumatic Cataract ◽  
Case Presentation ◽  
Iris Defect ◽  
Uncorrected Visual Acuity ◽  
Posterior Synechia ◽  
Anterior Segment Surgery

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

scholarly journals Urrets-Zavalia syndrome following posterior segment surgery: Case report and review of literature

2019 ◽  
Vol 147 (9-10) ◽  
pp. 636-638
Author(s):  
Dragan Vukovic ◽  
Antoaneta Adzic ◽  
Sanja Petrovic-Pajic
Keyword(s):  
Anterior Segment ◽  
Posterior Segment ◽  
Diagnostic Process ◽  
Partial Reduction ◽  
Review Of Literature ◽  
Scleral Buckle ◽  
Case Presentation ◽  
First Case ◽  
Anterior Segment Surgery ◽  
Iris Atrophy

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.

scholarly journals Open-Globe Injury With Intraocular Foreign Body

2020 ◽  
pp. 247412642096503
Author(s):  
Filippos Vingopoulos ◽  
Yvonne Wang ◽  
Seanna Grob ◽  
Chloe Yang Ling Li ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Foreign Body ◽  
Primary Repair ◽  
Anterior Segment ◽  
Case Series ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Open Globe ◽  
Time From Injury

Purpose: To investigate characteristics of Open Globe Injuries (OGI) that presented with Intra-Ocular Foreign Body (IOFB), along with their long-term visual outcomes and complications. Methods: Retrospective interventional consecutive case series of OGIs with IOFBs that presented at Massachusetts Eye and Ear from 2010 to 2015. Data collected included time from injury to OGI repair, location of IOFB, retinal detachment (RD) rate, presenting and final visual acuity and subsequent surgeries. Results: Fifty-seven consecutive cases of OGIs with IOFBs were included. Mean follow-up was 28 months and median time from injury to OGI repair was 0 days. Overall, 38/57 (66.7%) eyes achieved final vision of 20/40 or better and 43/57 (75.4%) 20/150 or better. Thirty-three cases had IOFBs in the anterior segment only, 24 cases had posterior segment involvement. Thirty percent of cases (17/57) were complicated by an RD, 58.3% (14/24) in the posterior versus 9.1% (3/33) in the anterior IOFB group ( P = .01). There were no cases of endophthalmitis. Posterior IOFB and higher zone of injury were risk factors for RD both at presentation (both P < .001) and post-primary repair (both P < .001). Posterior IOFB was associated with higher vitrectomy rates both at presentation ( P < .001) and post-primary repair ( P = .002) and worse long-term visual outcome ( P = .01). Conclusions: OGIs with IOFB involving the posterior segment are associated with higher complication and re-operation rates and worse visual prognosis compared to those involving the anterior segment only.

scholarly journals Clinical Application of Foldable Capsular Vitreous Bodies in the Treatment of Severe Ocular Trauma and Silicone Oil Dependent Eyes

2021 ◽  
Author(s):  
Hao Jiang ◽  
Chao Xue ◽  
Yanlin Gao ◽  
Ying Chen ◽  
Yan Wang
Keyword(s):  
Visual Acuity ◽  
Clinical Application ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Anterior Segment ◽  
Vitreous Body ◽  
Corneal Opacity ◽  
Ultrasound Biomicroscopy ◽  
Significant Difference

Abstract Background: Recently, a new type of foldable capsular vitreous body (FCVB) has been developed for clinical application to fill the vitreous cavity with vitreous substitutes. It may be an ideal substitute for the vitreous body in eyes with severe retinal detachment. The aim of this study was to assess the application of a foldable capsular vitreous body (FCVB) in the treatment of severe ocular trauma and silicone oil (SO) dependent eyes.Methods: A retrospective analysis was performed on the clinical application of FCVB in the treatment of severe ocular trauma and SO dependent eyes. The results of best-corrected visual acuity and intraocular pressure (IOP) evaluation, B-scan ultrasonography or color Doppler ultrasonography, ultrasound biomicroscopy, and anterior segment photography were recorded during follow-up. A paired t-test was used to compare the difference in IOP before and after FCVB implantation. Results: Seven eyes of seven patients were included in the 6 months follow-up. In all cases, B-scan ultrasonography and ultrasound biomicroscopy showed that FCVB adapted closely to the globe wall and ciliary body, thus supporting the retina. Visual acuity did not improve, except in one case from LP to HM. The mean±SD IOP was 9.29±1.60mmHg prior to FCVB implantation and 10.43±0.98mmHg after implantation, with no significant difference between these measurements (P=0.066). Five of the seven patients developed differing degrees of corneal opacity and keratopathy. Conclusions: FCVB implantation may be a safe and effective method for the treatment of severe ocular trauma and SO dependent eyes. However, corneal opacity and keratopathy are potential serious complications after surgery. Appropriate case selection and proper surgical time require further investigation.

scholarly journals Visual outcome of cataract surgery with IOL implantation in traumatic cataract among 189 children: The Lahan experience

2017 ◽  
Vol 5 (3) ◽  
pp. 1-10
Author(s):  
L R Puri ◽  
G S Shrestha
Keyword(s):  
Visual Acuity ◽  
Cataract Surgery ◽  
Anterior Segment ◽  
Visual Outcome ◽  
Traumatic Cataract ◽  
Eye Injuries ◽  
Iol Implantation ◽  
Wooden Stick ◽  
Time Of Presentation

Trauma is an important cause of monocular blindness in the developing world. This study aims to determine the demo­graphic profile and visual outcome of cataract surgery among the children with traumatic cataract. It was a prospective and longitudinal study of 189 consecutive children below 16 years who underwent cataract surgery with intra ocular lens (IOL) implantation for traumatic cataract at Sagarmatha Choudhary Eye Hospital, Lahan, Nepal from October 2012 to March 2014. Assessment included visual acuity measurement in the Snellen’s chart or the Cardiff card, anterior segment examina­tion with slit lamp, dilated fundus examination with the help of +20D lens in indirect ophthalmoscope, B-scan ultrasonogra­phy of posterior segment and objective and subjective refraction. Follow up was scheduled at first post-operative day, at dis­charge, one month and three months. Cause and type of trauma, demographic factors, surgical intervention, complications, and visual acuity was recorded. Among 189, majority of them were males (73%) and the average age was 8.8±3.6 years. The time of presentation ranged from 3 days to 8 years (median age two months). Wooden stick was the most common cause of injury (34.4%). The average preoperative visual acuity in logMAR scale was 1.6. The average postoperative visual acuity in logMAR scale was 0.8. Eye injuries with traumatic cataract are associated with significant visual impairment. Cataract surgery with intraocular lens implantation restores vision significantly.

scholarly journals Traumatic scleral wound dehiscence with filtering bleb formation after surgical repair of penetrating globe injury

2013 ◽  
Vol 5 (1) ◽  
pp. 136-137 ◽  
Author(s):  
A Ozkaya ◽  
Z Alkin ◽  
Y Acet ◽  
U Yigit
Keyword(s):  
Surgical Repair ◽  
Ocular Trauma ◽  
Anterior Segment ◽  
Wound Dehiscence ◽  
Rare Occurrence ◽  
Filtering Bleb ◽  
Bleb Formation ◽  
The Right ◽  
Blunt Ocular Trauma

Backgropund: Filtering bleb formation after surgical repair of penetrating globe injury is a rare occurrence. Case: A 45-year-old male who had undergone surgical repair of a corneoscleral laceration 16 months earlier presented to emergency room after blunt trauma to the left eye. His best-corrected visual acuities were 20/20 in the right eye and 20/25 in the left. An anterior segment examination found a conjunctival filtering bleb formation on scarred sclera at superotemporal location near the limbus. Anterior chamber was slightly shallow and the Seidel test was negative. Intraocular pressures were 17 mm Hg in the right eye, 7 mm Hg in the left. The fundus examination revealed no abnormal findings. The patient was treated with topical aplication of a steroid and a cycloplegic drop during three weeks. After 16 months follow-up, the visual acuity remained unchanged with the persistence of filtering bleb. IOP was 8 mm Hg in the left eye. Follow-up examinations showed no complications related to trauma. Conclusion: Blunt ocular trauma can cause dehiscence in old scleral scars and subsequent filtering bleb formation. Nepal J Ophthalmol 2013; 5(9):136-137 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7843

Vitreous Seed Classification and Regression Patterns in Eyes With Retinoblastoma

2020 ◽  
pp. 247412642095198
Author(s):  
Pukhraj Rishi ◽  
Yamini Attiku ◽  
Pradeep T. Manchegowda ◽  
Ashutosh Agarwal ◽  
Minal Sharma
Keyword(s):  
Medical Records ◽  
Anterior Segment ◽  
Seed Morphology ◽  
Posterior Segment ◽  
Ocular Toxicity ◽  
Kaplan Meier ◽  
Regression Pattern ◽  
Free Status ◽  
Vitreous Seeds

Purpose: This work subclassifies retinoblastoma vitreous seeds and evaluates the efficacy, regression patterns, and adverse effects of combination intravitreal melphalan and topotecan chemotherapy for resistant and recurrent vitreous seeds. Methods: A retrospective review of medical records was conducted of patients with retinoblastoma and resistant or recurrent vitreous seeds who were treated with intravitreal melphalan and topotecan injections from August 2014 to July 2018. Main outcome measures included regression pattern, time for regression, time for recurrence of seeds, treatment outcomes, and ocular toxicity. Results: Nineteen eyes received 138 intravitreal injections over 74 treatment sessions (mean, 7.26 injections per eye); vitreous seeds regressed in 18 eyes. Of cloud vitreous seeds, curvilinear (n = 2) and sphero-linear (n = 2) subtypes were observed. During regression, some sphere seeds showed an intermediary streak-like pattern and took longer to regress (mean, 11.13 ± 14.05 months and 11.67 ± 8.62 injections) than those without the intermediary streak-like pattern (mean, 3.55 ± 2.57 months and 4.2 ± 1.87 injections). Mean follow-up was 34.87 ± 21.09 months (median, 35 months; range, 11-96 months). Anterior segment toxicity was seen in 10 (53%) eyes and posterior segment toxicity in 5 (26%) eyes. Kaplan-Meier survival estimates for globe salvage at 2 years was 94% and 73% at 5 years. Kaplan-Meier survival for vitreous seed–free status was 94% at 2 years and 65% at 5 years. Conclusions: An expanded vitreous seed classification system that further subcategorizes hitherto unrecognized vitreous seed morphology is needed. An intermediate streaking process results in a prolonged regression time for sphere vitreous seeds.

scholarly journals Rieger’s Anomaly without Posterior Embryotoxon: A Rare Presentation

2020 ◽  
Author(s):  
. Shrinkhal ◽  
Mood Mahesh ◽  
Ajai Agrawal ◽  
Ramanuj Samanta ◽  
Anupam Singh
Keyword(s):  
Autosomal Dominant ◽  
Anterior Segment ◽  
Dominant Inheritance ◽  
Rare Presentation ◽  
Current Case ◽  
Anterior Segment Dysgenesis ◽  
Iris Defect ◽  
Ocular Defect ◽  
Diagnostic Criterion

Rieger’s anomaly is a rare congenital ocular defect with autosomal dominant inheritance, characterised by dysgenesis of the anterior segment. Ocular features of typical Reiger’s anomaly include a prominent anteriorly displaced Schwalbe's line (posterior embryotoxon), iris stromal hypoplasia, corectopia, and glaucoma. An atypical presentation of Rieger’s anomaly is described in the current case report. A 26-year-old female presented with diminution of vision in right eye and mild photophobia in both eyes, since childhood. On examination, it was recognised as an atypical isolated case of Rieger’s anomaly with several classical features including segmental full thickness iris defect and ectropion uveae. This was associated with total cataract in right eye and persistent pupillary membrane in left eye, without posterior embryotoxon and glaucoma. There were no other associated ocular or systemic anomalies. Patient was operated for cataract surgery in right eye under guarded visual prognosis. The postoperative visual acuity was 3/60, signifying pre-existing amblyopia. The patient was kept on close follow-up for the development of glaucoma. This is a rare case of Anterior Segment Dysgenesis (ASD) manifesting as atypical Rieger’s anomaly without posterior embryotoxon and any systemic association, signifying the fact that posterior embryotoxon is not an essential diagnostic criterion.

Ptosis Secondary to Anterior Segment Surgery and Its Repair in a Two-Year Follow-Up Study

2005 ◽  
Vol 219 (3) ◽  
pp. 129-135 ◽  
Author(s):  
Michele Altieri ◽  
Eleanor Truscott ◽  
Amy E.H. Kingston ◽  
Roberta Bertagno ◽  
Gianguido Altieri
Keyword(s):  
Anterior Segment ◽  
Follow Up Study ◽  
Anterior Segment Surgery

scholarly journals Surgical Outcome of Traumatic Cataract Following Corneal Perforation in Children in a Tertiary Eye Care Centre in Nepal

2016 ◽  
Vol 36 (1) ◽  
pp. 50-55
Author(s):  
Ujjowala Devi Shrestha ◽  
Srijana Adhikari
Keyword(s):  
Anterior Segment ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Corneal Perforation ◽  
Traumatic Cataract ◽  
Poor Visual Outcome ◽  
Corneal Scar ◽  
Post Traumatic ◽  
Nepalese Children ◽  
Better Than

Introduction: Traumatic paediatric cataract is challenging and its management is difficult. It is associated with other distortion of ocular anatomy and subsequent post- operative complication poses more problems. It is mostly unilateral. The purpose of this study is to assess the outcome of traumatic cataract following corneal perforation in Nepalese children in a tertiary eye hospital in Nepal.Material and Methods: It was a retrospective review of medical records of children who developed cataract following perforating corneal injuries. The study included 69 cases diagnosed as unilateral traumatic cataract over a period of 70 months (January 2010 till October 2015) at Tilganga Institute of Ophthalmology (TIO). Traumatic cataracts caused by other than the perforating corneal injuries were excluded from the study.Results: Children between 6 to 10 years of age had highest percentage of ocular trauma. Boys were more commonly affected than girls. Forty two percentages of children had visual outcome of better than or equal to 6/18.Poor visual outcome was mainly due to anterior segment pathology- corneal scar (14.49%).Posterior segment pathology like macular scar, vitreous haemorrhage and retinal detachment contributed to 7.34% of the cause.Conclusion: Outcome of the traumatic cataract surgery varied. Visual outcome of post traumatic cataract after corneal perforation was dependent on multiple factors like co- existence of the anterior and posterior segment trauma, per –operative and post-operative challenges. Prompt and good management of traumatic cataract can result in good visual outcome.J Nepal Paediatr Soc 2016;36(1):50-55

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