Gonioscopy in Traumatic Hyphema

Tønjum, Asbjørn M.

doi:10.1111/j.1755-3768.1966.tb08084.x

Cited by 43 publications

(18 citation statements)

References 18 publications

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“…The projectile masses were not extensively varied as it was observed that the ability to create an iridodialysis depended more on projectile velocity than on projectile mass. This observation is in agreement with conclusions reached by previous investigators (Delori et al 1969;Tonjum 1966;Weidenthal & Schepens 1966 area of the iridodialysis although the lens capsule remained intact. Using the tensile strength data, porcine iris tissue was calculated to have a tensile strength of 2.07 X 105 N/m2 f 0.19 X lo5 N/mn SD and human iris tissue a strength of 1.44 X 109 N/m'+0.18 X 105 N/mz SD.…”

Section: Resultssupporting

confidence: 95%

“…The enucleate porcine eye was chosen because of its similarity to the human in the anterior segment and its use in prior studies (Delori et al 1969;Weidenthal & Schepens 1966). Iridodialysis has been hypothesized to result from blunt impact causing a rapid expansion of the limbal ring beyond the elasticity of the iris tissue (Delori et al 1969;Weidenthal & Schepens 1966;Tonjum 1966) or a rapid pressure wave of aqueous impinging on the iris root where there is no posterior support from the lens (Miller & Stegmann 1986). These mechanisms do not require a living eye for the study of traumatic iridodialysis.…”

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confidence: 99%

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A quantitative animal model of traumatic iridodialysis

Kumar

Miller

Atebara

et al. 1990

Acta Ophthalmologica

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The impact velocities and kinetic energies necessary to create a particular form of ocular injury, traumatic iridodialysis, were quantitatively studied by experimentally traumatizing enucleate porcine eyes. Thicknesses and tensile strengths of porcine and human iris tissue were measured in order to allow for predictions of human results to be made from the animal model. Application of blunt trauma at an impact angle of 30-35 degrees with respect to the iris plane with striking of the eye at the corneolimbal junction was found to optimize tearing of the iris from the root. Using this vector, the minimum velocity for the creation of an iridodialysis at least 6 mm in length in the human eye is predicted to be 14 m/sec for impact with a projectile of 13.4 g with a 6 mm diameter tip.

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Section: Resultssupporting

confidence: 95%

mentioning

confidence: 99%

A quantitative animal model of traumatic iridodialysis

Kumar

Miller

Atebara

et al. 1990

Acta Ophthalmologica

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“…The ciliary injection and hyperemia of the iris were most pronounced from the second to the fourth day. Changes of pufiillary form, size, and mode of reaction of characteristic type, as discussed in a previous paper (Tonjum, 1966), were present in all cases.…”

Section: Res L;ltssupporting

confidence: 65%

“…Other possible, but not proved, hypertensive causes are transient hypersecretion of aqueous humor, and effusion of serous fluid from the iris and ciliary body tissues. Further, the hemorrhage caused by the trauma, and probably originated from ruptured arteries in the chamber angle (Tonjum, 1966), may give an initial increase of the intraocular volume and pressure; as an obstruction of the outflow passages is present, this hypertensive effect may be relatively long-lasting.…”

Section: IVmentioning

confidence: 99%

Intraocular Pressure Disturbances Early After Ocular Contusion

Tønjum

1968

Acta Ophthalmologica

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The intraocular pressure may change greatly after an ocular contusion. Both experiments in animals (Leplnt, 1924, Schmidt & de Decker, 1930, Larsson, 1932 and clinical studies in man (Leplat, 1924, Tillema. 1937, Delmarcelle & Weekers, 1957, Heydenreich, 1966 have shown variations of the intraocular pressure early after a blunt trauma; both increased and decreased intraocular pressure may be found. Most often a period of hypertension is followed by a period of hypotension.There is a lack of systematic studies on the course of the intraocular pressures in clinical materials. There is also a striking discrepancy in the literature as to the management of ocular contusions, both regarding the intraocular pressure and the hyphema.This calls for further information about the course of the intraocular pressure early after an ocular contusion resulting in hyphema. It was also supposed that tonographic evaluations might be informatory. Therefore the present longitudinal study of a specially selected sample of hospitalized patients was performed. M A T E R I A LThe present sample consists of 30 patients admitted to the University Eye Department 1964-66. Twenty-six were males and 4 females. The average age was 30 years, ranging from 10-64 years. The patients were routinely hospitalized for about 1 week, thereafter controlled as outpatients. They were chosen on certain criteria. A history of blunt trauma which had resulted in hyphema was obligatory, the hyphema was observed by the referring ophthal-

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“…The prevalence of cyclodialysis clefts following blunt ocular trauma is 2% to 5% or higher, [8,9] based on several studies examining gonioscopic findings in patients with a history of traumatic hyphema.…”

Section: Discussionmentioning

confidence: 99%

Novel surgical management of cyclodialysis cleft via anterior chamber perfusion

Tang

Wang

2017

Medicine

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Rationale:Cyclodialysis cleft is a relatively rare but severe condition with persistent ocular hypotony, which can cause morphologic changes and visual loss. Here we report a case of a traumatic cyclodialysis cleft that was successfully managed with direct cyclopexy via anterior chamber perfusion. During the operation, if there is aqueous humor flowing out of the deep scleral incision, the cleft is not closed, and surgery should continue until there is no aqueous outflow.Patient concerns:A 66-year-old man was treated for severe blunt ocular trauma of the left eye and a resultant cyclodialysis cleft, lens subluxation, choroidal detachment and a cataract. His intraocular pressure was 6 mm Hg, he presented with a shallow anterior chamber, phacodonesis, iridodonesis, 360° ciliary body detachment, and a suspicious cyclodialysis cleft in the 5 to 8 o’clock position.Diagnoses:ocular blunt trauma (left eye), cyclodialysis cleft (left eye), lens subluxation (left eye), choroidal detachment (left eye), cataract (both eyes).Interventions:The cataract was extracted by phacoemulsification and a posterior chamber intraocular lens was implanted with 2 capsular tension rings, one in the lens bag and the other in the ciliary sulcus. Throughout the following month, intraocular pressure fluctuated between 4 and 6 mm Hg and the ciliary body failed to reattach. A cyclopexy via anterior chamber perfusion was thus deemed necessary and performed.Outcomes:After cyclopexy, intraocular pressure increased to 27 mm Hg and decreased to 16 mm Hg after brinzolamide eye drops treatment twice daily for 4 days. Subsequently intraocular pressure stabilized between 10 to 21mm Hg. Complete closure of the cyclodialysis cleft was confirmed with ultrasound biomicroscopy.Lessons:Cyclopexy via anterior chamber perfusion for patients with cyclodialysis cleft is a simple, safe, and efficient technique that ensures a successful surgery.

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Gonioscopy in Traumatic Hyphema

Cited by 43 publications

References 18 publications

A quantitative animal model of traumatic iridodialysis

A quantitative animal model of traumatic iridodialysis

Intraocular Pressure Disturbances Early After Ocular Contusion

Novel surgical management of cyclodialysis cleft via anterior chamber perfusion

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