Are airbags a risk for patients after radial keratotomy?

Uchio, Eiichi; Kadonosono, Kazuaki

doi:10.1136/bjo.85.6.640

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…The value of 0.7, similar to our results with gelatin corresponds to the age 40-50. For human cornea the corresponding value is lower -only ~0.2 [23].…”

Section: Resultsmentioning

confidence: 90%

Multifocal laser surgery: Cutting enhancement by hydrodynamic interactions between cavitation bubbles

et al. 2010

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Transparent biological tissues can be precisely dissected with ultrafast lasers using optical breakdown in the tight focal zone. Typically, tissues are cut by sequential application of pulses, each of which produces a single cavitation bubble. We investigate the hydrodynamic interactions between simultaneous cavitation bubbles originating from multiple laser foci. Simultaneous expansion and collapse of cavitation bubbles can enhance the cutting efficiency, by increasing the resulting deformations in tissue, and the associated rupture zone. An analytical model of the flow induced by the bubbles is presented and experimentally verified. The threshold strain of the material rupture is measured in a model tissue. Using the computational model and the experimental value of the threshold strain one can compute the shape of the rupture zone in tissue resulting from application of multiple bubbles. With the threshold strain of 0.7 two simultaneous bubbles produce a continuous cut when applied at the distance 1.35 times greater than that required in sequential approach. Simultaneous focusing of the laser in multiple spots along the line of intended cut can extend this ratio to 1.7. Counterpropagating jets forming during collapse of two bubbles in materials with low viscosity can further extend the cutting zone-up to approximately a factor of 1.5.

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“…The value of 0.7, similar to our results with gelatin corresponds to the age 40-50. For human cornea the corresponding value is lower -only ~0.2 [23].…”

Section: Resultsmentioning

confidence: 90%

Multifocal laser surgery: Cutting enhancement by hydrodynamic interactions between cavitation bubbles

et al. 2010

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“…If they do break, they can lead to more severe penetrating injuries [ 25 ]. Some authors suggest that patients who have undergone eye surgery with corneal or scleral incisions may be more vulnerable to open-globe injury from blunt airbag trauma [ 14 , 26 , 27 , 28 ].…”

Section: Epidemiology Of Ocular Traumamentioning

confidence: 99%

Bilateral Angle Recession and Chronic Post-Traumatic Glaucoma: A Review of the Literature and a Case Report

Iannucci,

Manni,

Alisi

et al. 2023

Life

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Ocular trauma affects millions of people worldwide and is a leading cause of secondary glaucoma. Angle recession is the main cause of post-traumatic glaucoma after blunt eye trauma, and it is usually unilateral. The aim of this paper is to investigate the possible causes of angle recession with a bilateral presentation. Airbag activation during traffic accidents is a likely cause to be ruled out, along with repeated head or eye trauma, due to contact sports or a history of physical abuse. These aspects can aid in early detection, appropriate management, and improved outcomes for patients with ocular trauma. Finally, we report the case of a 75-year-old Caucasian man who developed a bilateral angle recession after an airbag impact, with advanced glaucoma in the right eye and ocular hypertension in the left eye. To our knowledge, this is the first case in the literature of chronic post-traumatic glaucoma probably caused by an airbag.

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“…RK incision dehiscence has been reported during phacoemulsification cataract surgery 2-4 corneal transplantation 5 and following blunt trauma including car airbag inflation. 6 Previous reports suggest considerable variability in corneal strength following RK. [2][3][4][5][6][7][8] We are aware of three published cases of RK incision rupture during phacoemulsification cataract surgery.…”

Section: Commentmentioning

confidence: 99%

“…6 Previous reports suggest considerable variability in corneal strength following RK. [2][3][4][5][6][7][8] We are aware of three published cases of RK incision rupture during phacoemulsification cataract surgery. Budak et al 2 reported RK incision dehiscence in a patient who had RK 11 months before cataract surgery.…”

Section: Commentmentioning

confidence: 99%

Delayed radial keratotomy dehiscence following uneventful phacoemulsification cataract surgery

Day

Seward

2007

Eye

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Sir, Delayed radial keratotomy dehiscence following uneventful phacoemulsification cataract surgery A 73-year-old female was referred with cataracts. Bilateral radial keratotomy (RK) had been performed 9 years previously for high myopia; on her left eye this had been supplemented with astigmatic keratotomies. Best-corrected visual acuities were 6/36 right eye and 6/12 left eye. She had bilateral moderate nuclear sclerotic cataracts. Fundoscopy showed healthy discs with a right epiretinal membrane and normal left macular. She chose to have left cataract surgery following detailed discussion with specific mention of complications associated with previous RK.Routine phacoemulsification cataract extraction was performed under subtenons anaesthesia. The clear corneal main incision was located temporally between RK incisions and was secured at the end of the procedure with a single 10/0 Vicryl suture. She was examined before discharge and had a deep anterior chamber and negative Siedel's test. Acetazolamide 250 mg was given for postoperative IOP prophylaxis.Day one review showed a shallow anterior chamber with two Seidel positive temporal RK incisions. She was taken to theatre and one incision closed with a 10/0 nylon suture and a bandage contact lens inserted (Figure 1). Four months postoperatively her visual acuity is 6/6 with refraction À0.25/À2.00 Â 7.5 CommentPrevious RK not only complicates intraocular lens power selection due to unintentional postoperative hyperopia and postoperative hyperopic shift, 1 but can also reduce corneal tensile strength. RK incision dehiscence has been reported during phacoemulsification cataract surgery 2-4 corneal transplantation 5 and following blunt trauma including car airbag inflation. 6 Previous reports suggest considerable variability in corneal strength following RK. [2][3][4][5][6][7][8] We are aware of three published cases of RK incision rupture during phacoemulsification cataract surgery. Budak et al 2 reported RK incision dehiscence in a patient who had RK 11 months before cataract surgery. This occurred during construction of a 3.0 mm incision that intersected one of the radial incisions. Following suturing of the wound, the remainder of the procedure was uneventful. In the other two cases, RK dehiscence occurred during the phacoemulsification stage. 3,4 In all cases there was very good visual rehabilitation.The reason why delayed RK dehiscence occurred in our patient is not known. The astigmatic keratotomy incisions traversing radial cuts will have further weakened the cornea compared with simple RK. As trauma to the eye is unlikely because the clear shield was only removed at the day one examination, we speculate

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Are airbags a risk for patients after radial keratotomy?

Cited by 7 publications

References 22 publications

Multifocal laser surgery: Cutting enhancement by hydrodynamic interactions between cavitation bubbles

Multifocal laser surgery: Cutting enhancement by hydrodynamic interactions between cavitation bubbles

Bilateral Angle Recession and Chronic Post-Traumatic Glaucoma: A Review of the Literature and a Case Report

Delayed radial keratotomy dehiscence following uneventful phacoemulsification cataract surgery

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