scholarly journals Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries

2022 ◽  
Vol 8 ◽  
Author(s):  
Huijin Chen ◽  
Jiarui Yang ◽  
Changguan Wang ◽  
Xuefeng Feng ◽  
Kang Feng ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Silicone Oil ◽  
Open Globe Injury ◽  
Oil Migration ◽  
Corrected Visual Acuity ◽  
Open Globe ◽  
Baseline Information ◽  
Suturing Methods

PurposeTo explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion.DesignProspective cohort, hospital-based study.MethodsA total of 24 patients who were diagnosed with choroidal avulsion were enrolled in this study. The demographic characteristics, baseline information of trauma, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected before surgery, and the anatomic abnormities of the globe were recorded before or during surgery. All patients were diagnosed with choroidal avulsion and underwent choroid suturing treatment during vitrectomy, postoperative functional variables including BCVA and IOP, anatomic variables including retinal and choroidal reattachment rate, and silicone oil migration rate, which were recorded at the regular follow-ups at least 1 year after surgery.ResultsAll patients with open globe injury involved zone III, 70.8% of the patients presented with two quadrants of the avulsed choroid, and 29.2% with one quadrant involved; moreover, all patients had complications with retinal detachment (RD), of which 58.3% of patients had closed funnel retinal detachment. TSS was applied in nineteen patients and IOS in five patients. Postoperatively, a significant improvement on LogMAR BCVA was observed at each follow-up from 3.57 ± 0.69 before surgery to 2.82 ± 0.98 at the last follow-up (p < 0.05), and the proportion of no light perception (NLP) was also reduced from 69.6 to 37.5%. IOP was markedly elevated from 6.4 ± 4.1 mmHg preoperatively to 11.3 ± 4.3 mmHg at the last follow-up (p < 0.05). Choroidal reattachment was achieved in 91.7% of patients; two patients were observed with silicone oil migration at 3 months after surgery and underwent drainage of suprachoroidal silicone oil and sclera buckling. Meanwhile, retinal attachment was observed in 95.8% of patients, only one patient developed partial RD due to postoperative proliferative vitreoretinopathy, and secondary vitrectomy was performed; all patients were observed with complete retinal and choroidal attachment at the last follow-up. Eventually, four patients were silicone oil-free, and 20 patients were silicone oil-dependent.ConclusionsChoroidal suturing proved to be an effective method to fix the avulsed choroid, which greatly improved the BCVA and maintained the IOP, and efficiently increased the choroidal and retinal reattachment rate and preservation of the eyeball.

scholarly journals Successful Management in a Case of Traumatic Retinal Detachment due to Open Globe Injury Using Microincisional Vitrectomy

2016 ◽  
Vol 7 (3) ◽  
pp. 476-480 ◽  
Author(s):  
Wei-Yu Lai ◽  
Tsung-Tien Wu
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Silicone Oil ◽  
Medical Center ◽  
Primary Repair ◽  
Surgical Techniques ◽  
Open Globe Injury ◽  
Open Globe ◽  
Silicone Oil Tamponade

Background: Retinal detachment (RD) following ocular trauma often results in guarded visual prognosis and sometimes leads to loss of the eye. With the advent of microincisional vitrectomy surgery and the development of surgical techniques, the management of ocular trauma has been transformed. Case Presentation: A 34-year-old man sustained an open globe injury from fragmented glass at work. He received primary repair and another follow-up surgery 9 days later, including vitrectomy, silicone oil tamponade, and lensectomy for RD and traumatic cataract at another medical center. However, his retina was totally detached and completely curled up in a roll with choroid on display when he was seen by us 1 month later. He was managed with vigilant and patient peeling and unfolding of the retina using a 23-gauge forceps and silicone oil tamponade, and achieved anatomical success and preservation of his eye at 6-month follow-up. Conclusions: This report demonstrates that even in cases which appear to be hopeless at presentation, the surgeon’s perseverance and surgical technique can salvage an eye that may otherwise be phthisical. It also encourages retinal surgeons to use microincisional vitrectomy to manage severe traumatic RD.

scholarly journals Endophthalmitis and Retinal Detachment after Ocular Injury by Animal Inoculation Needle

2021 ◽  
Vol 62 (9) ◽  
pp. 1305-1308
Author(s):  
Leeha Kwon ◽  
Yong-Wun Cho ◽  
Seong-Wook Seo ◽  
Seong-Jae Kim ◽  
In Young Chung ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Silicone Oil ◽  
Ocular Injury ◽  
Early Vitrectomy ◽  
Corrected Visual Acuity ◽  
Vitreous Prolapse ◽  
Oil Injection ◽  
Best Corrected Visual Acuity

Purpose: To report a case of endophthalmitis and retinal detachment after injury caused by an animal inoculation needle. Case summary: A 39-year-old man received an injury to his left eye with an animal inoculation needle while vaccinating a pig came to the hospital due to decreased visual acuity. At initial presentation, the best-corrected visual acuity in the left eye was “counting fingers,” and slit lamp examination revealed corneal lacerations, anterior capsule rupture, and traumatic cataract. Ultrasonography showed no specific findings in the vitreous and retina. Primary corneal suture, phacoemulsification, anterior vitrectomy due to rupture of the posterior capsule and vitreous prolapse, intraocular lens implantation, and intravitreal antibiotic injection were performed. On day 1 postoperatively, vitrectomy, anterior chamber irrigation, intravitreal antibiotic injection, and silicone oil injection were performed as signs of endophthalmitis, such as hypopyon and retinal tear, and focal retinal detachment were observed during surgery. Silicone oil removal was performed 7 months after the operation and the best-corrected visual acuity was 0.6. There has been no recurrence during follow-up. Conclusions: This is the first report in Korea of ocular injury caused by an animal inoculation needle. If the fundus is not observed in such injuries, there is a possibility of endophthalmitis and retinal detachment and early vitrectomy should be considered.

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

2018 ◽  
Vol 30 (2) ◽  
pp. 269-274 ◽  
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.

scholarly journals Reliability of the ocular trauma score for the predictability of traumatic and post-traumatic retinal detachment after open globe injury

2021 ◽  
Vol 14 (10) ◽  
pp. 1589-1594
Author(s):  
Simon Dulz ◽  
◽  
Toam Katz ◽  
Robert Kromer ◽  
Eileen Bigdon ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Ocular Trauma ◽  
Vitreous Hemorrhage ◽  
Open Globe Injury ◽  
Ocular Trauma Score ◽  
Open Globe ◽  
Significant Difference ◽  
Post Traumatic ◽  
Trauma Score

AIM: To elucidate the question of whether the ocular trauma score (OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment (RD) in patients with open globe injury (OGI). METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12mo follow-up and a median age at of 48.6y (range: 3-104y) were identified. Final best corrected visual acuity (BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score I (P<0.0001) or II (P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >III. OGI associated RD was observed in 36/102 patients (35.3%), whereas post traumatic RD (defined as RD following 14d after OGI) occurred in 37 patients (36.3%). OGI associated RD did not correlate with the OTS and the zone of injury (P=0.193), yet post traumatic RD correlated significantly with zone III injuries (P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone III injury with lower final BCVA and a higher number of surgeries, but only zone III could be significantly associated with a higher rate of RD.

Long-term natural history of highly myopic eyes with a dome-shaped macula with or without untreated serous retinal detachment: a 4-year follow-up study

2020 ◽  
pp. bjophthalmol-2020-316629
Author(s):  
Francesco Viola ◽  
Gaia Leone ◽  
Elena Garoli ◽  
Claudia Mainetti ◽  
Davide Galli ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Morphological Changes ◽  
Serous Retinal Detachment ◽  
Single Centre ◽  
Follow Up Study ◽  
Corrected Visual Acuity ◽  
Single Centre Study ◽  
History Of

PurposeTo evaluate the long-term functional and morphological changes occurring in myopic eyes with a dome-shaped macula (DSM), with or without untreated serous retinal detachment (SRD).MethodsThis prospective, single-centre study enrolled consecutive cases of highly myopic patients with DSM with or without a SRD. Patients underwent complete ophthalmological examinations, optical coherence tomography, axial length measurements and autofluorescence. Follow-up visits were performed with a maximum interval of 6 months for 4 years. Eyes with choroidal neovascularisation were excluded.ResultsTwenty-six eyes from 18 patients (mean age 61.2) were included. At baseline, 13 eyes had SRD and 13 did not. The DSMs were either horizontal (69%) or round (31%). There were no significant differences in best-corrected visual acuity (BCVA) between eyes with and without SRD during the 48-month follow-up period. Multivariate analysis showed that baseline BCVA was the only parameter among those analysed (age and SRD height) to have a significant effect on the final BCVA (p<0.0001). SRD fluctuated overtime and SRD height was significantly influenced by choroidal thickness (p=0.002). The scleral bulge thickness had no effect on SRD thickness.ConclusionsBCVA remained clinically stable over 4 years without treatment despite the fluctuations and persistence of the SRDs.

scholarly journals SOCIO-DEMOGRAPHIC AND CLINICAL PROFILE OF PEDIATRIC OCULAR TRAUMA: A HOSPITAL BASED PROSPECTIVE STUDY.

2019 ◽  
Vol 3 (12) ◽  
Author(s):  
Dev Kant ◽  
Jyoti Kumari ◽  
R. K. Singh
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Clinical Profile ◽  
Open Globe Injury ◽  
Corrected Visual Acuity ◽  
Open Globe ◽  
The Common ◽  
Ocular Injuries ◽  
Best Corrected Visual Acuity

Objectives: This present study was to evaluate the clinical and socio-demographical study in cases of paediatrics ocular injuries. Methods: A detail assessment and relevant investigations were performed to all paediatrics OCT. And globe injuries were recorded according to the BETT. Occular injury was examined by using equipment model OCT 2000 by TOPCON at IGIMS, Patna. Treatment was given depending on type and severity of injuries. Patients were followed up on day 1, day 7, 1 month, and at 6 months. Initial best corrected visual acuity was evaluated on first day of follow up. And final best corrected visual acuity (BCVA) was evaluated on last day of follow up after 6 months. Results: Data was analysed by using simple statistical methods with the help of MS-office software. All data was tabulated and percentage was calculated. Conclusions: Age group 0-10 years and males were more prone to ocular trauma. Stick, stone RTA and fall were more causative risk for OCT.  School, home, Road traffic accident were the common places for ocular trauma. Open globe injury and close globe injury were commonly seen in ocular trauma cases. Close globe injury patients were shows the better BCVA with respect to OGI, lids and lacrimal apparatus injury and non-mechanical injury. Hence, we should aware the parents and family members about the common modes of trauma, the need of supervision of the objects of play. Self-protection should be taught to children to prevent possible ocular injuries. Houses, playgrounds and schools must be made safe and common items of trauma such as sharp objects, household lime, acids must be kept out of reach of children. Intensive campaign may be done before festival seasons about safety measures to increase public awareness. Ocular trauma is a frequent reason for emergency room visits. Evaluation of eye injuries should start with visual acuity and continue with prompt referral to an ophthalmologist as indicated. Key words: Ocular trauma, clinical profile, open globe injury, close globe injury, BCVA

scholarly journals Changes of macular vessel density and thickness in gas and silicone oil tamponades after vitrectomy for macula-on rhegmatogenous retinal detachment

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Liu ◽  
Boya Lei ◽  
Rui Jiang ◽  
Xin Huang ◽  
Min Zhou ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Rhegmatogenous Retinal Detachment ◽  
Silicone Oil ◽  
Retinal Thickness ◽  
Vessel Density ◽  
Gas Tamponade ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Abstract Purpose To investigate the macular vessel density and thickness in macular-on rhegmatogenous retinal detachment (RRD) after vitrectomy with gas and silicone oil (SO) tamponade. Methods Patients with macular-on RRD eyes, treated with a single successful vitrectomy with gas or SO tamponade and a minimum 30 months follow-up, were reviewed. Best-corrected visual acuity (BCVA), macular vessel density and retinal thickness by using optical coherence tomography angiography, were compared to the contralateral eyes. Results Sixteen eyes with gas tamponade and 17 eyes with SO tamponade were included in the study. LogMAR best-corrected visual acuity (BCVA) slightly improved from 0.25 ± 0.18 (Snellen 20/36) to 0.17 ± 0.23 (Snellen 20/30) in eyes with gas tamponade, and decreased from 0.30 ± 0.22 (Snellen 20/40) to 0.49 ± 0.28 (Snellen 20/62) in eyes with SO tamponade. The parafoveal vessel densities in superficial vascular complex (SVC) and the corresponding inner retinal thickness (IRT) were similar between the affected eyes and the contralateral eyes in gas tamponade group (P = 0.578, P = 0.943), while significantly reduced in the affected eyes, compared to the contralateral eyes in SO tamponade group (P < 0.001, P < 0.001). Conclusion Eyes in SO tamponade group had worse BCVA, lower SVC vessel densities and thinner corresponding IRT after vitrectomy for macular-on RRD, than those in gas tamponade group.

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