1
|
Huang Y, Khan F, Chang M, Conrady CD, Yeh S. Utility of a nitinol stone extractor for intraocular foreign body removal. Am J Ophthalmol Case Rep 2023; 32:101917. [PMID: 37680307 PMCID: PMC10481175 DOI: 10.1016/j.ajoc.2023.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 08/01/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023] Open
Abstract
Purpose To describe the novel application of a urological instrument, the nitinol stone basket, in the removal of a retained intraocular foreign body (IOFB). Observations This is a retrospective case series describing two eyes of two patients presenting with metallic IOFBs after hammering metal-on-metal. Both patients underwent 23-gauge pars plana vitrectomy (PPV) and successful IOFB extraction using the NCircle® Nitinol Tipless Stone Extractor. There were no intraoperative or post-surgical complications. Both patients demonstrated improvement in vision, with most recent postoperative visual acuities of 20/40 and 20/60. Conclusions and importance The nitinol stone basket may be considered for removal of IOFBs, particularly larger IOFBs that are difficult to grasp with forceps. Our cases add to the literature showing favorable visual outcomes and few complications in the post-operative period using this technique.
Collapse
Affiliation(s)
- Ye Huang
- Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Farid Khan
- Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, USA
| | - Mark Chang
- Advanced Urology Centers of New York, West Nyack, NY, USA
| | - Christopher D. Conrady
- Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Steven Yeh
- Department of Ophthalmology and Visual Sciences, Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
2
|
Open Globe Injury (OGI) with a Presence of an Intraocular Foreign Body (IOFB)-Epidemiology, Management, and Risk Factors in Long Term Follow-Up. J Clin Med 2022; 12:jcm12010190. [PMID: 36614991 PMCID: PMC9821012 DOI: 10.3390/jcm12010190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/09/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
The purpose of the study was to evaluate visual outcomes and consider management strategies in the eyes with an intraocular foreign body (IOFB). In a single-center, retrospective case-control study, 36 eyes of 36 patients who suffered from open globe injury (OGI) with IOFB were admitted to the Department of Vitreoretinal Surgery of Medical University of Lublin, Poland from January 2015 to December 2020. Most frequent primary procedure was the pars plana vitrectomy (PPV) with IOFB removal (n = 28). Retinal detachment (RD) developed in nine eyes soon after injury or as a further complication. Recurrent retinal detachment occurred in eight of these nine cases. Final VA 0.1 or better was observed in 21 eyes (58%). Fifteen patients had BCVA of less than 0.1. One eye was not included in the final VA assessment due to the short follow-up period. In 25 out of 28 patients who underwent any kind of pars plana vitrectomy (ppV) a BCVA of <0.4 was observed. The prognosis after an IOFB injury is uncertain due to multiple factors in a peri- and postoperative period. Factors predisposing to poor visual outcomes are: IOFB localization in the posterior segment, retinal detachment, vitreous hemorrhage and prolonged silicone oil tamponade.
Collapse
|
3
|
Fine A, Pike D, Campbell RJ, Gonder T. Intraocular foreign bodies: a subtle clinical emergency. CAN J EMERG MED 2022; 24:893-895. [PMID: 36205911 DOI: 10.1007/s43678-022-00389-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 09/19/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Alexa Fine
- Department of Ophthalmology, Queen's University, Kingston, ON, Canada
| | - Damien Pike
- Department of Ophthalmology, Queen's University, Kingston, ON, Canada
| | - Robert J Campbell
- Department of Ophthalmology, Queen's University, Kingston, ON, Canada
| | - Tom Gonder
- Department of Ophthalmology, Queen's University, Kingston, ON, Canada.
| |
Collapse
|
4
|
Lüdtke L, Großjohann R, Tayar A, Stahl A, Tost F. [Ocular trauma from a vole trap]. DIE OPHTHALMOLOGIE 2022; 119:1064-1066. [PMID: 35024910 DOI: 10.1007/s00347-021-01566-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 01/26/2023]
Affiliation(s)
- Lisa Lüdtke
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland.
| | - Rico Großjohann
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Allam Tayar
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Andreas Stahl
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - Frank Tost
- Klinik für Augenheilkunde, Universitätsmedizin Greifswald, Greifswald, Deutschland
| |
Collapse
|
5
|
Gupta Y, Lomi N, Patil VS, Yadav S. Intralenticular metallic foreign body 'locked-in' the posterior capsule and the utility of multimodal imaging. BMJ Case Rep 2021; 14:e244104. [PMID: 34588201 PMCID: PMC8483024 DOI: 10.1136/bcr-2021-244104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Intraocular foreign bodies (FBs) are common ocular injuries reporting to the emergency services all over the world. The authors highlight the findings and surgical management of a case of intralenticular metallic FB following an injury while using chisel and hammer. The ocular path of the FB (2 mm) could be traced from a self-sealed corneal perforation, extending through the anterior capsule rupture, terminating at the posterior capsule, forming a posterior capsule tent with a part embedded in clear lens. Preoperative ultrasound biomicroscopy gave clues on posterior capsule integrity and the exact site of FB, and helped prognosticate and plan the surgical management of the case. The 'locked-in' FB was extracted after clear lens aspiration and posterior capsulorrhexis. The posterior capsule acted as a natural barrier between anterior and posterior segment, where the FB was found embedded.
Collapse
Affiliation(s)
- Yogita Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neiwete Lomi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vinay S Patil
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Saumya Yadav
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
6
|
Intraocular Foreign Body: Diagnostic Protocols and Treatment Strategies in Ocular Trauma Patients. J Clin Med 2021; 10:jcm10091861. [PMID: 33923011 PMCID: PMC8123265 DOI: 10.3390/jcm10091861] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 11/29/2022] Open
Abstract
Intraocular foreign bodies (IOFBs) are critical ophthalmic emergencies that require urgent diagnosis and treatment to prevent blindness or globe loss. This study aimed to examine the various clinical presentations of IOFBs, determine the prognostic factors for final visual outcomes, establish diagnostic protocols, and update treatment strategies for patients with IOFBs. We retrospectively reviewed patients with IOFBs between 2005 and 2019. The mean age of the patients was 46.7 years, and the most common mechanism of injury was hammering (32.7%). The most common location of IOFBs was the retina and choroid (57.7%), and the IOFBs were mainly metal (76.9%). Multivariate regression analysis showed that poor final visual outcomes (<20/200) were associated with posterior segment IOFBs (odds ratio (OR) = 11.556, p = 0.033) and retinal detachment (OR = 4.781, p = 0.034). Diagnosing a retained IOFB is essential for establishing the management of patients with ocular trauma. To identify IOFBs, ocular imaging modalities, including computed tomography or ultrasonography, should be considered. Different strategies should be employed during the surgical removal of IOFBs depending on the material, location, and size of the IOFB.
Collapse
|
7
|
Tirakunwichcha S, Pongsachareonnont P. Factors Associated with Visual Outcome after Primary Repair of Open-Globe Injury by Ophthalmology Residents in Training in a Tertiary Eye Center. Clin Ophthalmol 2021; 15:1173-1181. [PMID: 33790529 PMCID: PMC8005269 DOI: 10.2147/opth.s300753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/03/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To assess factors associated with visual outcome after open-globe injury (OGI) repair by trainees. Methods In this observational study, charts of OGIs repaired by trainees at King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok were retrospectively reviewed. Preoperative, intraoperative, and postoperative outcomes (day 1, month 1, and month 6 postoperation) were analyzed. Results A total of 78 OGIs presented in a 10-year period. A biphasic pattern was found among the young and the elderly. Approximately 73.6% of the cases had had surgical repair outside office hours. A majority of cases had been caused by machinery and hammers, and had visual acuity (VA) <20/200. Three cases were reported as having been unsuccessful intraoperatively for globe repair. A fifth of the cases required evisceration/enucleation within 2 weeks of presentation. Presenting VA worse than hand motion was associated with the risk of evisceration/enucleation (OR 14.5, P=0.013). VA improved at 6 months postoperation to the range of counting fingers and 20/200 (OR 15.6, P<0.01). High ocular trauma scores (OTSs) was associated with lower risk of evisceration/enucleation, and 12% retinal detachment (RD) was discovered, of which 90% occurred within 1 month after OGI repair. Conclusion Most OGIs were efficiently managed by the trainees, seldomly requiring assistance from subspecialists. Poor initial VA was associated with high risk of visual loss, whereas higher OTSs were inversely related to lower risk of evisceration or enucleation. There was a higher percentage of participants with final VA of 20/100-20/20 than the preoperative period. Precaution and careful evaluation of RD in the early postoperative period is recommended.
Collapse
Affiliation(s)
- Suppapong Tirakunwichcha
- Ophthalmic Plastic and Reconstructive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | - Pear Pongsachareonnont
- Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| |
Collapse
|
8
|
Rusňák Š, Hecová L. Transscleral Extraction of an Intraocular Foreign Body from the Posterior Segment of the Eye without Pars Plana Vitrectomy. CESKÁ A SLOVENSKÁ OFTALMOLOGIE : CASOPIS CESKÉ OFTALMOLOGICKÉ SPOLECNOSTI A SLOVENSKÉ OFTALMOLOGICKÉ SPOLECNOSTI 2020; 76:14-23. [PMID: 32917090 DOI: 10.31348/2020/2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE Penetrating eye trauma with an intraocular foreign body is very frequent, especially in men in their productive age. Pars plana vitrectomy would be the standard surgical method at our department. However, in indicated cases (metallic intraocular bodies in the posterior eye segment in young patients with well transparent ocular media without detached ZSM and without any evident vitreoretinal traction) transscleral extraction of the intraocular foreign body is performed using the exo magnet, eventually endo magnet with a minimal PPV without PVD induction under the visual control of endo-illumination. MATERIALS AND METHODS Between June 2003 and June 2018, 66 eyes of 66 patients diagnosed with a penetrating eye trauma caused by an intraocular foreign body located in the posterior eye segment were treated. In 18 eyes (27,3 %) with a metallic foreign body in vitreous (body) or in retina, no PPV or a minimal PPV without PVD was used as a surgical method. In the remaining 48 eyes (72,7 %), a standard 20G, respectively 23G PPV method were used together with PVD induction and the foreign body extraction via endo or exo magnet. CONCLUSIONS As demonstrated by our survey/study, in the cases of a thoroughly considered indication an experimented vitreoretinal surgeon can perform a safe NCT transscleral extraction from the posterior eye segment via exo magnet, eventually endo magnet under the visual control of a contact display system with a minimal PPV. Thereby, the surgeon can enhance the patient´s chance to preserve their own lens and its accommodative abilities as well as reduce the risk of further surgical interventions of the afflicted eye.
Collapse
|
9
|
Chee RI, Eliott D, Chau FY. Surgical Management of an Externally Protruding, Perforating Intraocular Foreign Body. Ophthalmic Surg Lasers Imaging Retina 2018; 49:904-906. [PMID: 30457652 DOI: 10.3928/23258160-20181101-14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ru-ik Chee Felix Y. Chau In this case of a perforating eye injury by a 2-inch-long nail that went through the cornea, lens, and posterior eye wall, the authors describe a combined external, anterior, and posterior segment surgical approach that resulted in safe and successful removal of the foreign body. Initial external trimming of the protruding nail facilitated the use of a noncontact viewing system. Combined limbal and pars plana placement of the vitrectomy cannulas optimized access to both anterior and posterior intraocular structures. Most importantly, careful removal of potential sources of foreign body adhesion to intraocular structures prior to extraction likely increased the likelihood for a successful clinical outcome. Care was taken to remove as much of the vitreous as possible and to keep the eye formed. The patient recovered 20/25+2 vision with aphakic correction.
Collapse
|
10
|
Mamas N, Andreanos K, Brouzas D, Diagourtas A, Droulias A, Georgalas I, Papaconstantinou D. Acute ocular pain during magnetic resonance imaging due to retained intraocular metallic foreign body: the role of ultrasonography and ultrasound biomicroscopy in diagnosis and management of this condition. J Ultrasound 2018; 21:159-163. [PMID: 29500812 PMCID: PMC5972104 DOI: 10.1007/s40477-018-0289-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/08/2018] [Indexed: 10/17/2022] Open
Abstract
PURPOSE To report the case of a 65-year-old metalworker with no known history of ocular trauma, who suffered from intense ocular pain during magnetic resonance imaging (MRI) of the brain, due to a retained intraocular metallic foreign body (IOFB). CASE REPORT Meticulous ophthalmological examination was inconclusive. An IOFB was confirmed with X-ray scan, whereas its exact localization was enabled by means of ultrasonography and ultrasound biomicroscopy (UBM). CONCLUSIONS Despite appropriate screening protocols, MRI-related ocular complications might occur in the presence of a hidden metallic IOFB. Clinical detection of ocular foreign bodies can sometimes be challenging. Ultrasonography and UBM are valuable adjuncts for the accurate localization, especially of small or hidden particles.
Collapse
Affiliation(s)
- Nikolaos Mamas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Mesogeion Ave 154, 15667, Athens, Greece.
| | - Konstantinos Andreanos
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Mesogeion Ave 154, 15667, Athens, Greece
| | - Dimitrios Brouzas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Mesogeion Ave 154, 15667, Athens, Greece
| | - Andreas Diagourtas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Mesogeion Ave 154, 15667, Athens, Greece
| | - Andreas Droulias
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Mesogeion Ave 154, 15667, Athens, Greece
| | - Ilias Georgalas
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Mesogeion Ave 154, 15667, Athens, Greece
| | - Dimitrios Papaconstantinou
- First Department of Ophthalmology, National and Kapodistrian University of Athens, Mesogeion Ave 154, 15667, Athens, Greece
| |
Collapse
|
11
|
McClellan AJ, Daubert JJ, Relhan N, Tran KD, Flynn HW, Gayer S. Comparison of Regional vs. General Anesthesia for Surgical Repair of Open-Globe Injuries at a University Referral Center. Ophthalmol Retina 2017; 1:188-191. [PMID: 28944317 DOI: 10.1016/j.oret.2016.11.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE This study compares the clinical features and physician selection of either Regional Anesthesia (peribulbar or retrobulbar block) with Monitored Anesthesia Care (RA-MAC) or General Anesthesia (GA) for open globe injury repair. DESIGN A non-randomized, comparative, retrospective case series at a University Referral Center. PARTICIPANTS All adult repairable open globe injuries receiving primary repair between January 1st, 2004 and December 31st, 2014 (11 years). Exclusion criteria were patients less than 18 years of age and those treated with primary enucleation. METHODS Data was gathered via retrospective chart review. MAIN OUTCOME MEASURES Data collected from each patient was age, gender, injury type, location, length of wound, presenting visual acuity, classification of anesthesia used, duration of the procedure performed, months of clinical follow-up, and final visual acuity. RESULTS During the 11 years study period, 448 patients were identified who had open globe injuries with documented information on zone of injury. Globe injury repair was performed using RA-MAC in 351/448 (78%) patients and general anesthesia in 97/448 (22%) patients. Zone 1, 2 and 3 injuries were recorded in 241, 135, and 72 patients respectively. The rates in specific zones, of RA-MAC versus GA were as follows: Zone 1 - 213/241 (88%) vs 28/241 (12%), Zone 2 - 104/135 (77%) vs 31/135 (23%) and Zone 3 - 34/72 (47%) vs 38/72 (53%). Open globe injuries repaired under RA-MAC had significantly shorter wound length (p<0.001), more anterior wound location (p<0.001) and shorter operative times (p<0.001). RA-MAC cases also had a better presenting and final visual acuity (p<0.001). Neither class of anesthesia conferred a greater visual acuity improvement (p=0.06). The use of GA did not cause any delay in the time elapsed from injury until surgical repair (p=0.74). CONCLUSIONS RA-MAC is a reasonable alternative to GA for the repair of open globe injuries in selected adult patients. RA-MAC was selected more often for Zone 1 and Zone 2 injuries. For eyes with Zone 3 injuries, there are equal selection ratio for RA-MAC and GA.
Collapse
Affiliation(s)
- Andrew J McClellan
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 17th Street, Miami, Florida, USA 33133
| | - Jacquelyn J Daubert
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 17th Street, Miami, Florida, USA 33133
| | - Nidhi Relhan
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 17th Street, Miami, Florida, USA 33133
| | - Kimberly D Tran
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 17th Street, Miami, Florida, USA 33133
| | - Harry W Flynn
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, 900 NW 17th Street, Miami, Florida, USA 33133
| | - Steven Gayer
- Department of Anesthesiology, University of Miami, Miller School of Medicine, 1611 NW 12th Ave, Miami, FL 33136
| |
Collapse
|
12
|
Intraoperative Macula Protection by Perfluorocarbon Liquid for the Metallic Intraocular Foreign Body Removal during 23-Gauge Vitrectomy. J Ophthalmol 2017; 2017:6232151. [PMID: 28553550 PMCID: PMC5434232 DOI: 10.1155/2017/6232151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 02/24/2017] [Accepted: 03/12/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose. To evaluate visual and safety outcomes of 23-gauge (G) pars plana vitrectomy (PPV) with application of perfluorocarbon liquid (PFCL) for intraoperative protection of the macula during intraocular foreign body (IOFB) removal. Methods. Retrospective study of 42 patients who underwent 23 G PPV for IOFB removal from posterior segment with intraoperative PFCL application for the macula shielding. Collected data included corrected distance visual acuity (CDVA), size of IOFB, and complication rate. The mean follow-up period was 12 months. Results. The mean preoperative CDVA was 0.54 logMAR (SD 0.46), and the final mean CDVA was 0.68 logMAR (SD 0.66). All IOFBs were metallic with mean dimensions of 4.6 mm × 2.1 mm. Twenty-two IOFBs were removed through the corneal tunnel and 20 IOFBs through the sclerotomy. No intraoperative iatrogenic lesion of the macula was observed. As a tamponade, silicon oil was applied in 31 eyes, SF6 gas in 5 eyes, air in 4 eyes, and 2 eyes required no tamponade. Secondary retinal detachment was observed in 17% of cases, but at the end of the follow-up, all the retinas were attached. Conclusion. PFCL application during PPV is a safe method of protecting the macula from unexpected falling of the metallic IOFB during its removal.
Collapse
|
13
|
Affiliation(s)
- Kunyong Xu
- Department of Ophthalmology (Xu), Queen's University, Kingston, Ont.; VitreoRetinal Surgery PA (Almeida), Minneapolis, Minn
| | - David R P Almeida
- Department of Ophthalmology (Xu), Queen's University, Kingston, Ont.; VitreoRetinal Surgery PA (Almeida), Minneapolis, Minn.
| |
Collapse
|
14
|
Pujari A, Bajaj M, Dubey D. Large intraocular foreign body following a firecracker injury. BMJ Case Rep 2016; 2016:bcr-2016-218565. [PMID: 27979850 DOI: 10.1136/bcr-2016-218565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Amar Pujari
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Mandeep Bajaj
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| | - Devashish Dubey
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, New Delhi, India
| |
Collapse
|
15
|
The sunflower cataract in Wilson's disease: pathognomonic sign or rare finding? Acta Neurol Belg 2016; 116:325-8. [PMID: 26577266 PMCID: PMC4989003 DOI: 10.1007/s13760-015-0566-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 11/03/2015] [Indexed: 12/18/2022]
Abstract
The presence of Kayser–Fleischer ring in patients with Wilson’s disease (WD) is well documented and included in diagnostic algorithms; however, data about the occurrence of the second postulated ophthalmological sign of WD, sunflower cataract (SC), are limited and even conflicting. The aim of our study was to verify the occurrence of SC in WD. From January 2010 to May 2015, 81 consecutive, newly diagnosed WD patients underwent detailed ophthalmological examinations, including slit lamp examination with special attention to lens transparency, to verify the presence of SC in WD-naive patients. SC was detected in only one (1.2 %) of the examined WD patients, did not impact visual acuity; moreover, completely disappeared following a year of treatment for WD. SC may be a very rare and reversible ophthalmological manifestation of WD that is observed seldom and only at the time of WD diagnosis. We postulate that a finding of SC in WD patients is an interesting finding that may occur in the course of WD, but it is not a pathognomonic sign of WD.
Collapse
|
16
|
Abstract
Open globe injury (OGI) is a severe form of eye trauma estimated at 2-3.8/100,000 in the United States. Most pediatric cases occur at home and are the result of sharp object penetration. The aim of this article is to review the epidemiology, diagnosis, management, and prognosis of this condition by conducting a systematic literature search with inclusion of all case series on pediatric OGI published between 1996 and 2015. Diagnosis of OGI is based on patient history and clinical examination supplemented with imaging, especially computed tomography when indicated. Few prospective studies exist for the management of OGI in pediatric patients, but adult recommendations are often followed with success. The main goals of surgical management are to repair the open globe and remove intraocular foreign bodies. Systemic antibiotics are recommended as medical prophylaxis against globe infection, or endophthalmitis. Other complications are similar to those seen in adults, with the added focus of amblyopia therapy in children. Severe vision decline is most likely due to traumatic cataracts. The ocular trauma score, a system devised to predict final visual acuity (VA) in adults, has proven to be of prognostic value in pediatric OGI as well. Factors indicating poor visual prognosis are young age, poor initial VA, posterior eye involvement, long wound length, globe rupture, lens involvement, vitreous hemorrhage, retinal detachment, and endophthalmitis. A thorough understanding of OGI and the key differences in epidemiology, diagnosis, management, and prognosis between adults and children is critical to timely prevention of posttraumatic vision loss early in life.
Collapse
Affiliation(s)
- Xintong Li
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Marco A Zarbin
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Neelakshi Bhagat
- Department of Ophthalmology, Rutgers New Jersey Medical School, Newark, NJ, USA
| |
Collapse
|
17
|
Nicoară SD, Irimescu I, Călinici T, Cristian C. Intraocular foreign bodies extracted by pars plana vitrectomy: clinical characteristics, management, outcomes and prognostic factors. BMC Ophthalmol 2015; 15:151. [PMID: 26526732 PMCID: PMC4631100 DOI: 10.1186/s12886-015-0128-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 10/12/2015] [Indexed: 11/15/2022] Open
Abstract
Background Intraocular foreign bodies (IOFBs) are an important cause of visual loss within the group of working age population. We aim to present the clinical features and the algorithm according to which we manage the foreign bodies that are located in the posterior segment of the eye. We define the outcomes and the prognostic factors that influenced the final visual acuity and globe survival in patients with IOFBs that we extracted by pars plana vitrectomy (PPV) over a 5-year period. Methods We reviewed the medical records of all the cases with IOFBs that we removed by PPV, over 5 years (2009–2013). We extracted the following parameters: age, gender, wound anatomy, IOFB characteristics, ocular lesions, initial and final visual acuities. We used the program SPSS version 20.0.0. for the statistical analysis of our data. Results During 5 years, we treated 21 IOFBs by PPV, representing 12.20 % of all the open globe injuries. All the patients were males with the median age of 36 years. The foreign body was located in the vitreous - 11 cases (52.38 %), retina - seven cases (33.33 %) and perforating - three cases (14.28 %). Retinal detachment (RD) at presentation was identified in eight cases (38.09 %) and endophthalmitis, in six cases (28.57 %). The visual outcome was significantly worse in patients with RD at presentation (p = 0.012) and with IOFBs larger than 3 mm (p = 0.042). Endophthalmitis did not influence the visual outcome. Conclusions The worse prognostic factors were: RD at presentation and large foreign body. Trial registration number IRCT2015040418966N3 / Apr. 9/2015
Collapse
Affiliation(s)
- Simona Delia Nicoară
- Department of Ophthalmology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 8, V. Babeș str, 400012, Cluj-Napoca, Romania.
| | - Iulian Irimescu
- Department of Neuroscience, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Tudor Călinici
- Department of Medical Informatics and Biostatistics, "Iuliu Hațieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
| | - Cristina Cristian
- Department of Ophthalmology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 8, V. Babeș str, 400012, Cluj-Napoca, Romania.
| |
Collapse
|
18
|
Ding J, Yoganathan P, Fernando-Sieminski S. Resolution of siderosis glaucoma from chronic intraocular foreign body without glaucoma surgery. Can J Ophthalmol 2015; 50:e82-5. [DOI: 10.1016/j.jcjo.2015.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 07/14/2015] [Accepted: 07/16/2015] [Indexed: 10/22/2022]
|
19
|
Wang K, Liu J, Chen M. Role of B-scan ultrasonography in the localization of intraocular foreign bodies in the anterior segment: a report of three cases. BMC Ophthalmol 2015; 15:102. [PMID: 26268356 PMCID: PMC4535674 DOI: 10.1186/s12886-015-0076-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 07/15/2015] [Indexed: 01/20/2023] Open
Abstract
Background The accurate localization of intraocular foreign bodies (IOFBs) is very important for the management of ocular trauma patients. B-scan ultrasonography is usually used to detect IOFBs in the posterior segment. Here, we report three cases with IOFBs in the anterior segment near the posterior lens capsule, which were accurately localized by B-scan ultrasonography under dynamic transversal scanning. Case presentation All three patients had a history of ocular trauma, and their clinical symptoms were compatible with the persistence of IOFBs. It was difficult to get a direct visualization of IOFBs with slit-lamp biomicroscopy because of opacities of the cornea and traumatic cataract. A computed tomography scan detected IOFBs in the anterior segment, but could not determine the exact location. Ultrasound biomicroscopy was performed but failed to show any IOFBs owing to the limited depth of penetration. B-scan ultrasonography was further applied but also failed to show any intraocular foreign bodies using axial scanning, a routine procedure of B-scan ultrasonography examination. However, using dynamic transversal scanning of B-scan ultrasonography, the accurate location of IOFBs was eventually shown to be embedded in the posterior lens cortex in case 1, adjacent to the posterior lens capsule in case 2, and located in the anterior vitreous close to the posterior lens capsule in case 3. Different surgical procedures were designed according to localization by B-scan ultrasonography, and all IOFBs were successfully removed. Conclusion B-scan ultrasonography is a simple and effective imaging modality in the localization of IOFBs in traumatic cataract. Transversal scanning is more suitable than axial scanning to detect IOFBs in the anterior segment near the posterior lens capsule.
Collapse
Affiliation(s)
- Kaijun Wang
- Eye Center, The 2nd Affiliated Hospital, Medical College of Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, China. .,Zhejiang Provincial Key Laboratory of Ophthalmology, Hangzhou, China.
| | - Jun Liu
- Eye Center, The 2nd Affiliated Hospital, Medical College of Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, China.
| | - Min Chen
- Eye Center, The 2nd Affiliated Hospital, Medical College of Zhejiang University, No. 88 Jiefang Road, Hangzhou, 310009, China. .,Zhejiang Provincial Key Laboratory of Ophthalmology, Hangzhou, China.
| |
Collapse
|
20
|
Jhun P, Aguilera P, Swaminathan A, Bright A, Herbert M. Use Safety Glasses, Save an Eye…Enough Said. Ann Emerg Med 2015; 65:637-9. [DOI: 10.1016/j.annemergmed.2015.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Images in emergency medicine. Young man with pain in right eye. Traumatic intraocular foreign body. Ann Emerg Med 2015; 65:636-48. [PMID: 26014215 DOI: 10.1016/j.annemergmed.2014.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/04/2014] [Accepted: 07/08/2014] [Indexed: 11/22/2022]
|
22
|
|
23
|
OCULAR INJURIES WITH A METALLIC FOREIGN BODY IN THE POSTERIOR SEGMENT AS A RESULT OF HAMMERING. Retina 2014; 34:1116-22. [DOI: 10.1097/iae.0000000000000062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Del Moro G, Fabris S, Longatti P, Scarpa G. Watch the Screw. An Unusual Complication of Orbital Reconstruction. J Oral Maxillofac Surg 2014; 72:645.e1-6. [DOI: 10.1016/j.joms.2013.11.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 10/25/2022]
|
25
|
Conrad-Hengerer I, Dick BH, Schultz T, Hengerer FH. Femtosecond laser–assisted capsulotomy after penetrating injury of the cornea and lens capsule. J Cataract Refract Surg 2014; 40:153-6. [DOI: 10.1016/j.jcrs.2013.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 07/02/2013] [Accepted: 07/17/2013] [Indexed: 10/25/2022]
|