scholarly journals Clinical Analysis of Adult Severe Open-Globe Injuries in Central China

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongling Chen ◽  
Junjun Han ◽  
Xianliang Zhang ◽  
Xuemin Jin

Purpose: To describe the characteristics, management, and outcomes of adult severe open-globe injured (OGI) eyes.Methods: Retrospective chart review of inpatients with initial visual acuity (VA) of light perception (LP) or no light perception (NLP) associated with OGI between 2017 and 2020 at Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan provincial People's Hospital.Results: Six hundred twenty-five eyes of 622 adult patients with initial VA of LP or NLP associated with open-globe injuries (OGIs) were included. The mean age was 47.8 ± 14.1 years with the range from 18 to 91 years. Significant male predominance was noted (81.5%). The most common type of these severe OGIs was rupture (65.8%). Traffic accidents accounted for 13.5% followed by fall/tumble (10.9%) and nail/wire (10.9%) of all the severe OGIs. Almost half of the injuries happened at workplace (47.2%). Initially, 78.7% eyes just received primary debridement and wound closure, while 8.5% eyes with no possible of anatomical reconstruction received evisceration. After initial management, 350 eyes received subsequent operation, including 239 eyes underwent vitrectomy + silicone oil/(+cataract remove). Finally, over 6 months follow-up, 137 eyes (21.9%) were eviscerated, 150 eyes (24.0%) got atrophied, while 132 eyes (21.1%) retain some VA. Fifty-three eyes (8.5%) got VA of 0.3–1.5.Conclusion: Severe OGIs are most seen in the young, middle-aged, and male working population and remain a serious public health problem, resulting in significant vision loss or Evisceration of eyes. Effective preventive measures should be taken for the individuals in these groups.

2020 ◽  
Author(s):  
Xin Wen ◽  
Miner Yuan ◽  
Cheng Li ◽  
Chongde Long ◽  
Zhaohui Yuan ◽  
...  

Purpose: To investigate the possible risk factors and prognosis of initial no light perception (NLP) in pediatric open globe injuries (POGI). Procedures: This retrospective, comparative, interventional case-control study included 865 eyes of POGI patients presenting to a tertiary referral ophthalmic center from 1 January 2011 to 31 December 2015. Eyes were divided into two groups: NLP group included eyes with initial NLP, and light perception(LP) group included eyes with initial LP or vision better than LP. Results: The following risk factors were significantly related to initial NLP: severe intraocular hemorrhage (OR=3.287, p=0.015), retinal detachment (RD) (OR=2.527, p=0.007), choroidal damage (OR=2.680, p=0.016) and endophthalmitis (OR=4.221, p<0.001). Choroidal damage is related to remaining NLP after vitreoretinal surgery (OR=12.384, p=0.003). At the last visit, more eyes in the NLP group suffered from silicone oil–sustained status (OR=0.266, p=0.020) or ocular atrophy (OR=0.640, p=0.004), and less eyes benefitted from final LP (OR=41.061, p<0.001) and anatomic success (OR=4.515, p<0.001). Conclusion: Severe intraocular hemorrhage, RD, choroidal damage and endophthalmitis occurred more often in POGI with initial NLP. Choroidal damage was the major factor related to an NLP prognosis. Traumatized eyes with initial NLP could be anatomically and functionally preserved by vitreoretinal surgery.


Author(s):  
Shohei Morikawa ◽  
Fumiki Okamoto ◽  
Yoshifumi Okamoto ◽  
Yoshinori Mitamura ◽  
Hiroto Ishikawa ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Simona Delia Nicoară ◽  
Iulian Irimescu ◽  
Tudor Călinici ◽  
Cristina Cristian

Purpose. To evaluate the outcome and identify the prognostic factors of traumatic endophthalmitis over a 5-year period.Methods. We reviewed the medical records of all the traumatic endophthalmities that we treated in our department over the last 5 years (2009–2013). We extracted the following parameters: age, gender, wound anatomy, associated ocular lesions, treatment, and initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data.Results. During the last 5 years, we treated 14 traumatic endophthalmities, representing 46.66% of all types of endophthalmities. The infection rate in open globe injuries was 8.13% and 34.78%, if an intraocular foreign body (IOFB) was associated. All the patients were males with the median age of 37 years. Initial visual acuities varied between light perception and 0.4 and the timing of treatment from a few hours to 10 days. We administered antibiotic and anti-inflammatory drugs, systemically and intravitreally, in all cases. We performed pars plana vitrectomy in 64.28% of cases. In 57.14% of cases, the final visual acuity was 0.1 or more.Conclusions. IOFBs increased significantly the risk for endophthalmitis. The worse prognostic factors were retinal detachment at presentation and delayed treatment. This trial is registered withIRCT2014082918966N1.


2015 ◽  
Vol 6 (2) ◽  
pp. 204-209 ◽  
Author(s):  
Tania A. Baban ◽  
Fady K. Sammouh ◽  
Haytham M. El Ballouz ◽  
Elias L. Warrak

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.


2011 ◽  
Vol 151 (3) ◽  
pp. 522-528 ◽  
Author(s):  
Ahmed Nashed ◽  
Parykshit Saikia ◽  
Wolfgang A. Herrmann ◽  
Veit-Peter Gabel ◽  
Horst Helbig ◽  
...  

2018 ◽  
Author(s):  
Yan He ◽  
Songwen Nian ◽  
Nan Wu ◽  
Yi Wang ◽  
Tao Yu ◽  
...  

Abstract Background: Ocular trauma is one of the major threats of monocular blindness in children. The purpose of the study was to investigate the epidemiology, clinical characteristics and surgical outcomes of pediatric ocular trauma in southwest of China. Methods: The medical records of all patients with ocular trauma under 12 years old receiving three-port pars plana vitrectomy (PPV) in Southwest Eye Hospital from January 2007 to December 2017 were retrospectively analyzed in this study. Data records included age, gender, cause, type and time of injury, initial and final visual acuity (VA), type and times of operation. Results: This study included 122 eyes of 122 pediatric patients over a 11-year period. The mean age was 6.6 ± 3.2 years with a male-to-female ratio of 4.3:1. There were 100 (82%) open globe injuries (OGI) and 22 (18%) closed globe injuries. Of the open globe injuries, penetrating injury caused by sharp metal objects accounted for the highest percentage (70%). PPV could significantly improve VA in children with ocular trauma (P ˂ 0.01). In addition, the successful rate of PPV was not related with the age (P = 0.23) but significantly associated with intraocular tamponade (P < 0.05). Conclusions: The most common predisposing factor of pediatric ocular trauma in southwest of China was sharp metal objects resulting in penetrating injury. In our study, gas tamponade for vitrectomy had the highest successful rate, followed by balanced salt solution (BSS) and silicone oil. Unlike the age and injury classification, the preoperative VA was a solid prognostic indicator of postoperative vision.


2020 ◽  
Author(s):  
Lukas Reznicek ◽  
Christian S. Mayer ◽  
Ramin Khoramnia ◽  
Jakob Siedlecki ◽  
Benedikt Schworm

Abstract BACKGROUND: Epidemiology and evaluation of posterior segment involvement as a prognostic factor for functional outcome of patients with open globe injuries in a university eye clinic as a tertiary referral center in Southern Germany. METHODS: A retrospective analysis of 151 consecutive patients with open globe injuries who were referred to the department of Ophthalmology of the Technical University of Munich in Germany from 2004 to 2011 was conducted. Visual acuity, epidemiologic data, classification of the injuries including the ocular trauma score (OTS), performed surgeries, post-operative visual acuity and intraocular pressure (IOP) as well as correlation analyses between OTS and post-operative visual acuity were obtained. RESULTS: On total, 147 eyes were included in the study. The mean age of the patients was 42.9±22.2 years, 78.2% were male, 36.7% of injuries occurred in the workplace. Thirty-eight patients (25.9%) had intraocular foreign bodies (IOFB): 84.2% were metal objects, 5.3% organic material and 10.5% glass. On total, 51.7% of the open globe injuries were located in zone I (cornea, cornealscleral limbus), 15.0% in zone II (up to 5 mm posterior the sclerocorneal limbus) and 32.0% in zone III (posterior of zone 2). Affected structures were eyelids (17.7%), cornea (74.8%), iris (63.9%), lens (56.5%), sclera (48.3%), retina (47.6%) and optic nerve (19.7%). Mean preoperative BCVA was 1.304±0.794 logMAR and 1.289±0.729 logMAR after surgery (p=0.780). Patients with involvement of their posterior segment had significantly worse postoperative BCVA scores than patients without (1.523±0.654 logMAR vs. 0.944±0.708 logMAR, p<0.01). CONCLUSIONS: Predictive factors for good visual outcome of open globe injuries are good initial visual acuity and ocular trauma affecting only zone I and II.


2019 ◽  
Vol 10 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Filipe Sousa Neves ◽  
Joana Braga ◽  
Paula Sepúlveda ◽  
Miguel Bilhoto

The purpose of this case report is to describe a modified technique involving the use of an autologous neurosensory retinal free flap for closure of a macular hole (MH) during retinal detachment (RD) surgery. A 50-year-old female presented with sudden vision loss (light perception only) and a recurrent myopic RD associated with an MH. An autologous neurosensory retinal free flap was obtained and moved toward the MH. Silicone oil was used as an endotamponade and removed after 6 months. Two months after oil removal visual acuity improved to 20/400 and remained stable thereafter; however, the patient developed central retinal atrophy. One year after surgery the MH was closed and the retina attached. This modified technique with the use of an autologous neurosensory retinal flap provides an alternative approach for recurrent MH in RD procedures.


Author(s):  
Tomasz K. Wilczyński ◽  
Alfred Niewiem ◽  
Rafał Leszczyński ◽  
Katarzyna Michalska-Małecka

A 36-year-old patient presented to the hospital with recurrent dislocation of the intraocular lens (IOL). The patient with the diagnosis of familial ectopia lentis was first operated on for crystalline lens subluxation in the left eye in 2007 and in the right eye in 2009. In both eyes, lens extraction with anterior vitrectomy and transscleral fixation of a rigid IOL was performed. In 2011, the IOL in the right eye luxated into the vitreous cavity due to ocular trauma. The patient underwent a pars plana vitrectomy with the IOL resuturation to the sclera. Seven years later, a spontaneous vision loss in the right eye was caused by a retinal detachment. The pars plana vitrectomy with silicone oil tamponade and a consequential oil removal three months later were performed in 2018. The follow-up examination revealed recurrent IOL dislocation in the same eye. Due to a history of previous suture-related complications a decision was made to remove the subluxated rigid polymethyl-methacrylate (PMMA) IOL and fixate to sclera a sutureless SOLEKO FIL SSF Carlevale lens. The purpose of this report is to present a single case of a 36-year-old patient who was presented to the hospital with recurrent dislocation of the intraocular lens. In a three-month follow-up period, a good anatomical and functional outcome was finally obtained with transscleral sutureless intraocular lens. This lens is an option worth considering especially in a young patient with a long life expectancy and physically active.


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