ABSTRACT
Purpose: To explore the efficacy of ultrasound biomicroscopy (UBM) as a tool for detecting and localizing intrascleral chestnut burr spines. Methods: Individuals who were diagnosed with definitive or suspected intrascleral chestnut burr injuries between 2019 and 2020 were retrospectively reviewed. All patients underwent UBM to detect potential intrascleral spines. UBM imaging features were recorded and analyzed. Intrascleral spines were removed based upon UBM?guided localization. Patient clinical profiles, management, and treatment outcomes were recorded. Results: A total of 10 eyes (10 patients; 6 males, 4 females) were diagnosed with intrascleral spines over the study period, with an average patient age of 55 years (range: 39–71). Three of these 10 eyes exhibited involvement of the palpebrae and cornea, whereas three exhibited corneal involvement, and the remaining four patients exhibited only intrascleral spine injuries owing to their having undergone previous intracorneal spine extraction procedures. UBM features consistent with chestnut burr spines manifest a hyperechoic spot with a shadow. UBM enabled the precise localization of these spines and thus ensured their successful removal via a single surgery. During follow?up, two patients experienced vitreous hemorrhage due to a penetrating injury into the ciliary body that was gradually absorbed. All patients with eye irritation and red eyes progressed favorably, and no surgical complications were recorded. Conclusion: A retained scleral chestnut burr spine should be suspected if a patient complains of persistent eye irritation following intracorneal spine removal. UBM may be a valuable tool for detecting spines retained in the sclera, enabling the successful removal thereof.
ABSTRACT
Aim: To study the efficiency and safety of iris reconstruction combined with iris‑claw intraocular lens (IOL) implantation in the patients with iris‑lens injuries. Settings and Design: Retrospective, noncomparable consecutive case series study. Materials and Methods: Eleven patients (11 eyes) following iris‑lens injuries underwent iris reconstructions combined with iris‑claw IOL implantations. Clinical data, such as cause and time of injury, visual acuity (VA), iris and lens injuries, surgical intervention, follow‑up period, corneal endothelial cell count, and optical coherence tomography, were collected. Results: Uncorrected VA (UCVA) in all injured eyes before combined surgery was equal to or <20/1000. Within a 1.1–4.2‑year follow‑up period, a significant increase, equal to or better than 20/66, in UCVA was observed in six (55%) cases, and in best‑corrected VA (BCVA) was observed in nine (82%) cases. Postoperative BCVA was 20/40 or better in seven cases (64%). After combined surgery, the iris returned to its natural round shape or smaller pupil, and the iris‑claw IOLs in the 11 eyes were well‑positioned on the anterior surface of reconstructed iris. No complications occurred in those patients. Conclusions: Iris reconstruction combined with iris‑claw IOL implantation is a safe and efficient procedure for an eye with iris‑lens injury in the absence of capsular support.