ABSTRACT
BACKGROUND: The purpose of this study was to present a modified surgical technique involving pars plana vitrectomy with large chorioretinectomy for eyes with rupture of the globe due to severe ocular blunt trauma. METHODS: This retrospective study included consecutive patients with rupture of the globe due to blunt trauma who were treated at the King Khaled Eye Specialist Hospital (Riyadh, Saudi Arabia). All patients underwent 25-gauge pars plana vitrectomy with large chorioretinectomies involving all the tissue around the posterior scleral wounds. Outcome measures included best-corrected visual acuity (BCVA), anatomical success and globe survival, rates of complications. RESULTS: 15 eyes of 15 patients were included. Mean BCVA was 2.88 ± 0.13 logMAR at presentation, and significantly improved to 0.83 ± 0.28 logMAR (P < 0.001), with 10 patients (67%) achieving a final BCVA ≥ 20/200. Anatomical success and globe survival were achieved in 11 (73%) and 15 (100%) of eyes, respectively. Postoperative complications included retinal detachment in 6 eyes (40%), epiretinal membrane in 6 (40%), hypotony in 4 (26%), PVR in 2 (13%). CONCLUSIONS: Pars plana vitrectomy with large chorioretinectomy is an effective treatment for globe rupture following severe blunt trauma, yielding good visual outcomes and anatomical success rates.
ABSTRACT
BACKGROUND AND OBJECTIVE: To describe a safe illumination technique in advanced pediatric tractional retinal detachments. PATIENTS AND METHODS: A 50-week-old premature infant with stage 5 retinopathy of prematurity was managed utilizing this technique. The surgical technique is demonstrated using a video. RESULTS: A non-trocar chandelier illumination system was used safely to provide adequate illumination for bimanual dissection. CONCLUSION: This technique allows working under chandelier illumination in a controlled fashion in advanced stages of pediatric ischemic vitreoretinopathies. [Ophthalmic Surg Lasers Imaging Retina. 2019;50:235-237.].
Subject(s)
Disease Management , Lighting/instrumentation , Retinal Detachment/surgery , Vitrectomy/methods , Equipment Design , Female , Humans , Infant, Newborn , IrisABSTRACT
PURPOSE: To compare the incidence, microbial profile, management and outcomes of endophthalmitis after glaucoma drainage implant (GDI), or trabeculectomy over 2 separate time periods before and after the year 2000. METHODS: A chart review was performed for patients with endophthalmitis after trabeculectomy (trabeculectomy group) or GDI group between 1983 to 1999 (group 1) and 2000 to 2011 (group 2) at a tertiary care hospital. Data were compared between groups and time periods. RESULTS: There were 56 cases of endophthalmitis after trabeculectomy in group 1 and 17 cases in group 2. After GDI, there were 10 cases of endophthalmitis in group 1 and 1 case in group 2. The incidence of endophthalmitis after GDI decreased significantly from 0.0105% to 0.00074% in groups 1 and 2, respectively (P<0.05). The incidence of endophthalmitis decreased significantly after trabeculectomy from 0.007% in group 1 to 0.00197% in group 2 (P=0.0004). There were 26 culture-positive cases in group 1 and 10 in group 2. The most common isolates were Streptococcus species in group 1 and Staphylococcus species in group 2. Indicators of morbidity were lower in group 2. The final visual outcome in either group was not correlated to the type of surgery, microbes, or initial management. CONCLUSIONS: There was a greater incidence of endophthalmitis after trabeculectomy compared with GDI. The incidence of endophthalmitis decreased from 2001 to 2011 compared with 1983 to 1999, which is likely due to advances in surgical technique. However, significant visual morbidity does occur despite prompt treatment.
Subject(s)
Endophthalmitis/epidemiology , Eye Infections, Bacterial/epidemiology , Glaucoma Drainage Implants/adverse effects , Glaucoma/surgery , Postoperative Complications , Trabeculectomy/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Bacteria/isolation & purification , Child , Endophthalmitis/drug therapy , Endophthalmitis/microbiology , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/microbiology , Female , Humans , Incidence , Intraocular Pressure/physiology , Male , Middle Aged , Retrospective Studies , Saudi Arabia/epidemiology , Tertiary Care Centers , Visual Acuity/physiologyABSTRACT
PURPOSE: To evaluate the function of the canaliculus with fistula after canalicular laceration repair. METHODS: Patients with monocanalicular fistula following canalicular laceration repair were evaluated with dye disappearance test (DDT). Temporary collagen plugs were used to occlude the uninvolved canaliculus in the ipsilateral eye and the corresponding canaliculus in the contralateral eye. After 24 hours of placement of the temporary plugs, the same evaluation was repeated. RESULTS: Ten patients with unilateral monocanalicular fistulas were evaluated. None of the patients had epiphora before and after placement of temporary plugs and DDT, and tear meniscus continued to be normal both in the affected and the unaffected eyes after temporary plug placement. CONCLUSIONS: In this series, the presence of canalicular fistula at the site of repair did not affect tear drainage.
