A clinical case of surgical correction of post-traumatic aphakia

Author(s):  
K.S. Khusanbaev ◽  
◽  
A.F. Yusupov ◽  
A.A. Abdushukurova ◽  
T.F. Sultonmurodov ◽  
...  

Purpose. To present a clinical case of surgical treatment of post-traumatic aphakia by the method of corneoscleral IOL fixation using the combined method of Kanabrava and Kozhukhov. Material and methods. In March 2021, patient A., born in 1992, turned to the RSSPCEM. diagnosed with OS Condition after a penetrating injury to the eye. Corneal scar. Post-traumatic aphakia. Foreign body (non-metallic) driven into the retina. A decision was made on OS surgical treatment of aphakia by the method of transscleral IOL fixation as the most gentle method, taking into account the paracentral scar of the cornea. And do not remove the foreign body, but additionally restrict it with laser coagulates. Results. On the 14th day after the operation, visual acuity OS 0.7, IOP 18. The eye is calm, there is a scar on the cornea in the paraoptic zone, transparent in the rest of the zone, the anterior chamber is deep, the iris is subatrophic, the pupil is 3 mm, deformed, the IOL is in the posterior chamber, centered. The fundus of the eye: the optic disc is pale pink, the boundaries are clear, the reflex is blurred in the macular zone, the foreign body is limited by pigmented laser coagulates. The standard postoperative drop regimen is recommended. Conclusions. 1. Corneoscleral fixation of the IOL according to the combined method of Canabrava and Kojuhov in the aphakic eye in complicated cases allows to achieve good refractive results with the developed technique of execution. 2. Preliminary laser limitation of an encapsulated non-metallic foreign body gives confidence in the stability of the retina in the intra- and postoperative period. 3. Further clinical observations are required using the above-described surgical technique for correcting aphakia Key words: сorneoscleral fixation, aphakia, Canabrava, Kojuhov.

2017 ◽  
Vol 4 (3) ◽  
pp. 120-122
Author(s):  
V.V. Boyko ◽  
V.V. Makarov ◽  
A.L. Sochnieva ◽  
V.V. Kritsak

Boyko V.V., Makarov V.V., Sochnieva A.L., Kritsak V.V.Residual foreign bodies in soft tissues are one of the main causes of chronical infection lesions and decrease in life quality. Surgical treatment is the most common way to relieve the patient from a foreign body. Often there is a question whether to remove a foreign body? On the one hand, all foreign bodies that are in the human body must be removed. On the other hand, in the absence of symptoms, the risk of surgery performed for the purpose of removal exceeds the risk associated with finding the foreign body. We would like to describe a practical case of removing a foreign body (Kirschner`s wires) from the left supraclavicular region. The young patient lived with a fragment of Kirschner's wire left after the osteosynthesis of the fractured clavicle for 5 years. Surgery to remove the residual foreign body was successful. On the 7th postoperative day the patient was discharged from the hospital under the supervision of surgeons at the place of residence.Key words: foreign body in soft tissue, Kirschner`s wire, surgical treatment. КЛІНІЧНИЙ ВИПАДОК ВИДАЛЕННЯ ЗАЛИШКОВ СТОРОННЬОГО ТІЛА З ЛІВОЇ НАДКЛЮЧИЧНОЇ ОБЛАСТІБойко В.В., Макаров В.В., Сочнева А.Л.,  Крицак В.В.Залишкові чужорідні тіла м'яких тканин залишаються однією з основних причин виникнення вогнища хронічної інфекції та зниження рівня якості життя. Хірургічне лікування основний спосіб позбавити хворого від наявності чужорідного агента. Часто виникає питання чи видаляти чужорідне тіло. З одного боку, усі сторонні тіла, що знаходяться в тілі людини, підлягають видаленню, з іншого боку при відсутності симптомів ризик операції, проводимої з метою видалення, перевищує ризик, пов'язаний з перебуванням чужорідного тіла. Ми хотіли б поділитися випадком видалення залишкового стороннього тіла (спиці Кіршнера) лівої надключичної ділянки із власної практики. Молода пацієнтка прожила з уламком спиці Кіршнера, залишеної після металлоостеосинтезу поламаної ключиці протягом 5 років. Операція з видалення залишкового стороннього тіла пройшла успішно. На 7 післяопераційну добу пацієнтка була виписана зі стаціонару під спостереження хірурги за місцем проживання.Ключові слова: чужорідне тіло м'яких тканин, спиця Кіршнера, хірургічне лікування. кЛИНИЧЕСКИЙ СЛУЧАЙ УДАЛЕНИЯ ОСТАТКОВ ИНОРОДНОГО ТЕЛА ИЗ ЛЕВОЙ ПОДКЛЮЧИЧНОЙ ОБЛАСТИ Бойко В.В., Макаров В.В., Сочнева А.Л.,  Крицак В.В.Остаточные инородные тела мягких тканей остаются одной из основных причин возникновения очага хронической инфекции и снижения уровня качества жизни. Хирургическое лечение основной способ избавить больного от наличия чужеродного агента. Часто возникает вопрос удалять ли инородное тело? С одной стороны, все инородные тела, находящиеся в теле человека, подлежат удалению, с другой стороны при отсутствии симптомов риск операции, производимой с целью удаления, превышает риск, связанный с нахождением инородного тела. Мы хотели бы поделится случаем удаления остаточного инородного тела (спицы Киршнера) левой надключичной области из собственной практики. Молодая пациентка прожила с обломком спицы Киршнера, оставленной после металлоостеосинтеза поломанной ключицы в течении 5 лет. Операция по удалению остаточного инородного тела прошла успешно. На 7 послеоперационные сутки пациентка была выписана из стационара под наблюдение хирурги по месту жительства.Ключевые слова: инородное тело мягких тканей, спица Киршнера, оперативное лечение.


2021 ◽  
Vol 23 (2) ◽  
pp. 91-98
Author(s):  
Gennady G. Bulyschenko ◽  
Alexey I. Gayvoronsky ◽  
Pavel S. Liev ◽  
Mikhail V. Kuznetsov ◽  
Dmitry V. Svistov

A clinical case of treatment of a patient with long-term consequences of a gunshot wound to the lumbar spine with a follow-up period of fifteen years is presented. In the last year and a half, the repeatedly recurrent retroperitoneal phlegmon associated with a foreign body of the lumbar spine has prompted a decision on the issue of surgical treatment (removal of a foreign body - a bullet). The location of the foreign body and previous experience with endoscopic foreign body removal played a decisive role in the choice of surgical tactics. Removal of the wounding projectile was performed using a percutaneous transforaminal endoscopic approach. The choice of such an approach was dictated by the peculiarity of the location of the foreign body (coaxial with the endoscopic tube in the foraminal approach), as well as sufficient experience in using the technique of percutaneous endoscopic surgery. At the same time, the conversion plan was worked out in sufficient detail with both posterolateral and anterior open approaches with the involvement of appropriate specialists. So, in case of failure, it was planned to transfer endoscopic access to open, using the already installed working tube of the endoscope as a conductor to a foreign body. In case of inefficiency, for some reason, this version of the operation was planned for the next, third stage: wound suturing, patient turning on the back with a right-hand retroperitoneal approach to the anterior-lateral surface of LI and LII bodies. Fortunately, the purpose of the operation was achieved using the most gentle version of the allowance. The given clinical case testifies that the technique of percutaneous transforaminal endoscopic surgery is not limited in indications to the treatment of degenerative-dystrophic diseases of the spine.


2019 ◽  
Vol 12 (7) ◽  
pp. e228325 ◽  
Author(s):  
Ana Sousa Menezes ◽  
Nuno Daniel Ribeiro Martins da Costa ◽  
Filipa Carvalho Moreira ◽  
Daniela Ribeiro

We report the clinical case of a female patient who presented to our emergency department due to a septal abscess caused by the displacement of a dental implant into the nasal septum. The patient underwent surgical treatment for endoscopic foreign body excision and septal abscess drainage. Despite the presence of septal cartilage destruction, the L-shaped structure was preserved and no reconstruction was required. Postoperative healing was uneventful.


2019 ◽  
Vol 4 (7) ◽  
pp. 430-444 ◽  
Author(s):  
Inmaculada Moracia-Ochagavía ◽  
E. Carlos Rodríguez-Merchán

It is essential to know and understand the anatomy of the tarsometatarsal (TMT) joint (Lisfranc joint) to achieve a correct diagnosis and proper treatment of the injuries that occur at that level. Up to 20% of Lisfranc fracture-dislocations go unnoticed or are diagnosed late, especially low-energy injuries or purely ligamentous injuries. Severe sequelae such as post-traumatic osteoarthritis and foot deformities can create serious disability. We must be attentive to the clinical and radiological signs of an injury to the Lisfranc joint and expand the study with weight-bearing radiographs or computed tomography (CT) scans. Only in stable lesions and in those without displacement is conservative treatment indicated, along with immobilisation and initial avoidance of weight-bearing. Through surgical treatment we seek to achieve two objectives: optimal anatomical reduction, a factor that directly influences the results; and the stability of the first, second and third cuneiform-metatarsal joints. There are three main controversies regarding the surgical treatment of Lisfranc injuries: osteosynthesis versus primary arthrodesis; transarticular screws versus dorsal plates; and the most appropriate surgical approach. The surgical treatment we prefer is open reduction and internal fixation (ORIF) with transarticular screws or with dorsal plates in cases of comminution of metatarsals or cuneiform bones. Cite this article: EFORT Open Rev 2019;4:430-444. DOI: 10.1302/2058-5241.4.180076


Author(s):  
U.S. Fayzieva ◽  
◽  
M.D. Gulyamova ◽  
O.I. Ikramov ◽  
◽  
...  

Purpose. To study the clinical efficacy of the long-term results of a step-by-step method of surgical treatment of open eye trauma complicated by the presence of the intraocular foreign body (IFB) in the posterior segment, including primary surgical treatment (PST) and delayed vitreoretinal surgery with IFB extraction within 24 hours after PST. Material and methods. The clinical efficacy of delayed IFB removal within 2 years was studied in 32 eyes with open trauma of the eyeball complicated by the presence of IFB in the posterior segment. Concomitant traumatic complications included partial hemophthalmos (84.4%) and rhegmatogenous retinal detachment (RD) (59.4%). Results. By the end of 2 years of follow-up, the anatomical effect was observed in all examined 21 eyes, including 15 eyes (71.4%) with hemophthalmos and 13 eyes (61.9%) with traumatic retinal detachment. In this case, recurrence of RD occurred in 7 eyes, post-traumatic traction RD- in 3 eyes. Functional effect with improved visual acuity was in 12 eyes (57.1%). At the same time, the MCVA was 0.3±0.05 (0.15–0.5). Conclusion. The presented method made it possible to achieve a stable anatomical effect and stable functional results, even in the presence of severe trauma complicated by total hemophthalmos and retinal detachment, in the long term. Key words: open eyeball injury, intraocular foreign body, primary surgical treatment, transvitreal intraocular foreign body extraction, post-traumatic traction retinal detachment.


2020 ◽  
Vol 24 (3) ◽  
pp. 409-412
Author(s):  
V. V. Kernychnyi ◽  
A. I. Sukhodolya

Annotation. The article presented a rare clinical case of a successful treatment of cancer of the descending colon, that is complicated by acute obstructive intestinal obstruction on the background of post-traumatic left diaphragmatic hernia in a 68-year-old patient. The result of surgical treatment indicates some possible unexpected intraoperative difficulties that the surgeon might be facing with during the process of a surgery. It is noticed that in surgery for a cancer of the descending colon, had been complicated by an acute intestinal obstruction, it is still necessary to find the cause of abdominal pain, had been accompanied by bloating, lack of stool and gas, vomiting “feils”, one of which may be postpartum of left hernia of the diaphragm.


1970 ◽  
Vol 4 (1) ◽  
pp. 187-190 ◽  
Author(s):  
P Aggarwal ◽  
P Garg ◽  
HK Sidhu ◽  
S Mehta

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


2021 ◽  
Vol 20 (1) ◽  
pp. 31-34
Author(s):  
Oleksandr Plaksyvyi ◽  
Ihor Kalutskyi ◽  
Olga Mazur ◽  
Taras Kotyk

Iatrogenic foreign bodies of the paranasal sinuses are extremely rare and, as a rule, during medical procedures. In this clinical case, a fracture of the needle for puncture of the maxillary sinus required surgical treatment.


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