Primäres Management offener Bulbusverletzungen

Viestenz, Arne; Fiorentzis, Miltiadis; Seitz, Berthold

doi:10.1055/s-0042-121625

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…The risk of a ruptured globe due to blunt trauma is 27 times higher in eyes after intraocular intervention (Viestenz et al, ). The incidence of traumatic dehiscence after PKP is between 1.3% and 5.8% (Rehany, ; Tseng et al, ).…”

Section: Discussionmentioning

confidence: 99%

Traumatic globe rupture after deep anterior lamellar keratoplasty—A novel management technique

et al. 2017

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A traumatic wound dehiscence can occur many years after surgery in 2-6% of all keratoplasties. Intraocular tissue prolapse can lead to severe visual loss. Deep anterior lamellar keratoplasty (DALK) leads to higher wound stability because of the intact Descemet membrane. We report a case of a novel management of wound dehiscence following DALK. A 59-year-old patient underwent uncomplicated DALK for advanced keratoconus. Eighteen months later he experienced a traumatic wound dehiscence (globe rupture) after a fall. Visual acuity decreased to light perception on the affected eye, the iris and prolapsed vitreous were incarcerated, and no retinal details were recognizable. The corneal graft was dehiscent over eight clock hours, the Descemet membrane was ruptured, and the stroma dissolved over 30% of its surface in a bell shape. Primary wound closure was performed with nylon 10-0 single interrupted corneal sutures. One day after emergency treatment, a 23-gauge pars-plana-vitrectomy for vitreous hemorrhage was conducted and a retinal tear was treated with laser photocoagulation. The Descemet membrane was repositioned using a 23 g vitrectomy probe under air and the globe was filled with SF 6 gas. Postoperatively, visual acuity increased to 6/15 and the cornea cleared up. Corneal graft and Descemet membrane repositioning after trauma can avoid a further keratoplasty and the risk of immunological rejection of donor endothelial cells.

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Section: Discussionmentioning

confidence: 99%

Traumatic globe rupture after deep anterior lamellar keratoplasty—A novel management technique

et al. 2017

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“…TMFs kommen häufiger bei jüngeren Patienten vor, da der Glaskörper oft noch anliegt [5]. Jüngere Menschen sind häufiger körperlich aktiv in Rahmen von Sportaktivitäten, Arbeit, Transport und sind wiederum anfälliger für Augenverletzung [1,6,7]. Huang et al berichten, dass Männer (86,3 vs. 27,7 %) und Patienten mit einem bereits reduzierten Visus häufiger betroffen sind [6].…”

Section: Introductionunclassified

Traumatisches Makulaforamen

Fiorentzis

Seitz

Viestenz

2018

Klin Monatsbl Augenheilkd

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The traumatic macular hole (TMH) is a rare complication of a blunt or an open injury of the globe and can lead to permanent loss of vision. The pathomechanism of TMH differs from that of the idiopathic macular hole (IMH). A sudden compression and expansion of the globe leads to vitreous traction, which can result in a TMH. The final visual acuity depends on the severity of the disruption of the photoreceptors and the retinal pigment epithelial cells. The posttraumatic approach is discussed controversially. A spontaneous closure and, therefore, a conservative approach should be considered in young patients with minor defects and good visual acuity without detachment of the posterior vitreous body. In these cases, it is advisable to wait for months. In the absence of adhesion at the edges of the hole and concomitant pathologies of the pigment epithelium, the spontaneous closure is improbable. In this case, a pars plana vitrectomy with removal of the vitreous and epiretinal membranes can lead to anatomical reconstruction and improvement of the visual acuity. The success of an operative intervention is complex and is associated with the experience of the surgeon as well as the characteristics of the trauma.

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Intraocular Epithelial Ingrowth after Traumatic and Surgical Corneal Injuries

Heinzelmann,

Stoica,

Vogt

et al. 2024

Diagnostics

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Intraocular epithelial ingrowth is a rare but serious complication of eye surgery or trauma. The diagnosis is challenging but can be aided by techniques such as anterior optical coherence tomography (AS-OCT). This study aimed to compare clinical and histopathological diagnostic data to evaluate the accuracy of AS-OCT. This retrospective analysis focused on patients presenting with suspected epithelial invasion between 2017 and 2022. Clinical data and histopathological findings were analyzed for diagnostic confirmation. Immunohistochemistry using the corneal-specific marker cytokeratin 3 and the conjunctival-specific marker cytokeratin 13 helped to identify the type of invading epithelial cells. Statistical analysis was used to evaluate the effectiveness of AS-OCT for diagnosis. This study included 51 patients who underwent keratoplasty or enucleation. Sixteen cases (31%) of epithelial ingrowth were histologically confirmed. The most common type was the cystic form (82%). Enucleation was required in 25% of patients, mainly due to diffuse epithelial invasion. Immunohistochemistry revealed a conjunctival origin in 82% of the infiltrated cells. AS-OCT showed a sensitivity of 78% and a specificity of 26% in detecting hyperreflective structures associated with epithelial invasion. This study highlights the diverse manifestations of epithelial ingrowth and the need for improved diagnostic techniques, with AS-OCT showing promising results but requiring further validation to avoid misdiagnosis.

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Primäres Management offener Bulbusverletzungen

Cited by 3 publications

References 15 publications

Traumatic globe rupture after deep anterior lamellar keratoplasty—A novel management technique

Traumatic globe rupture after deep anterior lamellar keratoplasty—A novel management technique

Traumatisches Makulaforamen

Intraocular Epithelial Ingrowth after Traumatic and Surgical Corneal Injuries

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