BACKGROUND We report a case of eye-penetrating injury in which a massive silicone oil migration into the patient’s subconjunctival space and orbit occurred after vitrectomy.CASE SUMMARY A 30-year-old male patient sou...BACKGROUND We report a case of eye-penetrating injury in which a massive silicone oil migration into the patient’s subconjunctival space and orbit occurred after vitrectomy.CASE SUMMARY A 30-year-old male patient sought medical attention at Ganzhou People’s Hospital after experiencing pain and vision loss in his left eye due to a nail wound on December 9,2023.Diagnosis of penetrating injury caused by magnetic foreign body retention in the left eye and hospitalization for treatment.On December 9,2023,pars plana vitrectomy was performed on the left eye for intraocular foreign body removal,abnormal crystal extraction,retinal photocoagulation.Owing to the discovery of retinal detachment at the posterior pole during surgery,silicone oil was injected to fill the vitreous body,following which upper conjunctival bubble-like swelling was observed.Postoperative orbital computed tomography(CT)review indicated migration of silicone oil to the subconjunctival space and orbit through a self-permeable outlet.On December 18,2023,the patient sought treatment at the First Affiliated Hospital of Nanchang University,China.The patient presented with a pronounced foreign body sensation following left eye surgery.On December 20,2023,the foreign body was removed from the left eye frame and an intraocular examination was conducted.The posterior scleral tear had closed,leading to termination of the surgical procedure following supplementary laser treatment around the tear.The patient reported a significant reduction in ocular surface symptoms just one day after surgery.Furthermore,a notable decrease in the migration of silicone oil was observed in orbital CT scans.CONCLUSION The timing of silicone oil injection for an eye-penetrating injury should be carefully evaluated to avoid the possibility of silicone oil migration.展开更多
Objective: To evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies. Methods: A total of 62 consecutive cas...Objective: To evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies. Methods: A total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow up ranged from 3 to 36 months (mean 12.5 months). Results: Ten eyes developed endophthalmitis, among which 7 ( 10.94 %) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis ( 44.44 %, 4/9). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eyes with endophthalmitis and two without endophthalmitis were eviscerated. Conclusions: Post traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis. Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.展开更多
AIM:To explore the traumatic endophthalmitis in young children and the outcome of pars plana vitrectomy(PPV).METHODS:Twenty-two eyes of 22 cases of young children consecutive pediatric traumatic endophthalmitis treate...AIM:To explore the traumatic endophthalmitis in young children and the outcome of pars plana vitrectomy(PPV).METHODS:Twenty-two eyes of 22 cases of young children consecutive pediatric traumatic endophthalmitis treated and followed up between September 2014 and May 2018 were included.Aqueous humor or vitreous samples were taken for bacterial culture and sensitivity tests.Intravitreal antibiotics(norvancomycin and ceftazidime)injection,combined with 23-gauge PPV,were administered in 22 eyes.Silicone oil(SO;5000 centistoke)tamponade or perfluoropropane gas(C3F8)was used in all patients.Main outcome measures were best-corrected visual acuity(BCVA)and retinal attachment,the ratio of penetrating injury,and the existence of intraocular foreign body.RESULTS:The mean age of patients was 6.9±2.2(range,3-10)y.All injured eyes suffered from penetrating ocular injury with retained intraocular foreign body in one eye.Bacterial culture was positive in only 2 eyes.The mean follow-up time was 21.1±4.7(range,12-30)mo.In the primary PPV,intravitreal antibiotics was administrated in all eyes,SO in 18 eyes,and C3F8 in 4 eyes.The secondary operation of SO removal and C3F8 endotamponade was performed in 16 eyes and a second SO endotamponade due to emulsification of the oil and retinal detachment(RD)was operated in 7 eyes underwent 3 to 11.5 mo after primary PPV.A third operation was done in 7 eyes.The final intraocular pressure(IOP)was 8.9±1.8(range,6.9-11.4)mm Hg.The final BCVAs were 20/200 or better in 5,counting fingers in 2,and light perception to hand movement in 8 eyes.Whose(66.7%)had retinal injury exhibited worse BCVA(P=0.019,Fisher’s exact test).Eyes underwent SO tamponade exhibited worse final BCVA than that with C3F8 in the primary PPV(P=0.026,Fisher’s exact test).CONCLUSION:Traumatic endophthalmitis in children is generally more severe and associated with more complicated surgical procedures.Most patients have retinal injury need multiple operations and the final BCVA is poor.Prevention of ocular trauma,especially in children,is still critical.展开更多
A case of retained intralenticular iron piece with signs of mild anterior uveitis at the time of presentation is reported in a 45 year-old man. His vision improved with topical cycloplegics and corticosteroids. After ...A case of retained intralenticular iron piece with signs of mild anterior uveitis at the time of presentation is reported in a 45 year-old man. His vision improved with topical cycloplegics and corticosteroids. After six months, his vision deteriorated grossly due to cataract formation. He regained good vision following removal of foreign body, extracapsular extraction with posterior chamber intraocular lens implantation. This case highlights the conservative management of the condition till the patient develops cataract resulting in visual disability; and good visual recovery following cataract surgery with intraocular lens implantation.展开更多
AIM:To report the outcomes of patients undergoing anterior segment optical coherence tomography-guided transepithelial phototherapeutic keratectomy(ASOCT T-PTK)for central corneal scarring after pterygium excision.MET...AIM:To report the outcomes of patients undergoing anterior segment optical coherence tomography-guided transepithelial phototherapeutic keratectomy(ASOCT T-PTK)for central corneal scarring after pterygium excision.METHODS:The charts of 11 eyes of 10 patients that underwent ASOCT T-PTK following excision of visual axisinvolving pterygia were retrospectively reviewed from a single private practice institution.The visual outcomes and corneal topographic findings were evaluated 4±1 mo after pterygium excision and 6±2 mo after transepithelial phototherapeutic keratectomy(T-PTK).RESULTS:All 11 eyes tolerated both the pterygium excision and T-PTK procedure well without any significant intraoperative or postoperative complications.Uncorrected distance visual acuity(UDVA)and manifest refraction corrected distance visual acuity(CDVA)improved after pterygium excision(P=0.03 and P=0.05,respectively).The UDVA and CDVA improved further after T-PTK(P=0.004 and P=0.002,respectively).The topographic surface asymmetry index,topographic surface regularity index,and topographic projected visual acuity significantly improved after T-PTK(P=0.0092,P=0.0022,and P=0.0002,respectively).None of the subjects lost any lines of CDVA,developed recurrence of pterygia or required keratoplasty during the postoperative period.CONCLUSION:ASOCT T-PTK can provide excellent visual and anatomic outcomes in patients with central corneal scarring after excision of visual axis-involving pterygia.展开更多
Purpose:Given the increased risk of accidents in patients with attention deficit and hyperactivity dis-order(ADHD)or maternal anxiety/depression,we aimed to investigate the frequency of the two diseases in children wi...Purpose:Given the increased risk of accidents in patients with attention deficit and hyperactivity dis-order(ADHD)or maternal anxiety/depression,we aimed to investigate the frequency of the two diseases in children with penetrating eye injury(PEI).Methods:Altogether 79 children,39 with PEIs and 40 healthy individuals(control group),aged 5-15 years,underwent a complete ophthalmologic examination.Afterwards,schedule for affective disorders and schizophrenia for school-aged children was conducted to assess the psychiatric diagnosis of all children.Turgay diagnostic and statistical manual of mental disorders(DSM-Ⅳ)-based child and adolescent behavior disorders screening and rating scale(T-DSM-Ⅳ-S)was flled by parents to evaluate the severity of ADHD symptoms.The depression and anxiety levels of mothers of each group were evaluated by two self-report measures:the Beck depression scale and the state-trait anxiety inventory(STAI),respectively.Data were analyzed by IBM SPSS version 22.0.The Chi-square and Fisher's exact test were used to determine whether there is a significant difference between qualitative variables while independent sample t and Mann-Whitney U tests to compare quantitative variables.Results:The only diagnostic difference was a significantly higher frequency of ADHD among patients with PEIs(48.7%in PEI vs.17.5%in control group,χ^2=7.359,p=0.007).The total scores of the T-DSM-Ⅳ-S(attention subscale U=418.000,p=0.006;hyperactivity subscale U=472.000,p=0.022)and maternal state-trait anxiety inventory(maternal STAI-state U=243.00,p=0.003;maternal STAl-trait U=298.000,p=0.021)were significantly higher in the PEI group than in control group.In logistic regression,children with PEI had a tendency to have a 3.5-fold increased risk for ADHD(OR=3.538,CI=0.960-13.039,p=0.058).Conclusion:ADHD was detected almost 1 in 2 children with PEls.Besides,the maternal anxiety level was significantly higher in the PEI group than in the control group.This association should be further explored via a future prospective longitudinal study.Since a proper treatment of ADHD in children and anxiety treatment in mothers may prevent vision loss following PEIs in children.展开更多
BACKGROUND Intralenticular foreign body is rarely encountered in ophthalmic practice.In most cases,subsequent traumatic cataract requires cataract surgery for visual rehabilitation.CASE SUMMARY A 35-year-old man was i...BACKGROUND Intralenticular foreign body is rarely encountered in ophthalmic practice.In most cases,subsequent traumatic cataract requires cataract surgery for visual rehabilitation.CASE SUMMARY A 35-year-old man was injured by iron filings in his left eye.After the injury,the patient tried to draw the object out by himself using a magnet;however,the foreign body(FB)was pushed to the equator of the lens.The FB was removed by a magnet through the anterior chamber accessed through the original capsular wound.Since most of the lens was transparent and only partially opaque after the operation,the lens was kept under close observation.After the surgery,the patient’s visual acuity reached 20/20 from 2/20,visual function recovered very well,and local opacity of the lens remained stable.CONCLUSION For intralenticular FB in the anterior cortex under the capsule,magnet may be a more advantageous way to remove the object.展开更多
基金National Natural Science Foundation of China,No.82160207Technology Plan of Jiangxi Provincial Health and Health Commission,No.202130156+1 种基金Young Scholar Project of the First Affiliated Hospital of Nanchang University,No.YFYPY202219Science and Key Projects of Jiangxi Youth Science Fund,No.20202ACBL216008.
文摘BACKGROUND We report a case of eye-penetrating injury in which a massive silicone oil migration into the patient’s subconjunctival space and orbit occurred after vitrectomy.CASE SUMMARY A 30-year-old male patient sought medical attention at Ganzhou People’s Hospital after experiencing pain and vision loss in his left eye due to a nail wound on December 9,2023.Diagnosis of penetrating injury caused by magnetic foreign body retention in the left eye and hospitalization for treatment.On December 9,2023,pars plana vitrectomy was performed on the left eye for intraocular foreign body removal,abnormal crystal extraction,retinal photocoagulation.Owing to the discovery of retinal detachment at the posterior pole during surgery,silicone oil was injected to fill the vitreous body,following which upper conjunctival bubble-like swelling was observed.Postoperative orbital computed tomography(CT)review indicated migration of silicone oil to the subconjunctival space and orbit through a self-permeable outlet.On December 18,2023,the patient sought treatment at the First Affiliated Hospital of Nanchang University,China.The patient presented with a pronounced foreign body sensation following left eye surgery.On December 20,2023,the foreign body was removed from the left eye frame and an intraocular examination was conducted.The posterior scleral tear had closed,leading to termination of the surgical procedure following supplementary laser treatment around the tear.The patient reported a significant reduction in ocular surface symptoms just one day after surgery.Furthermore,a notable decrease in the migration of silicone oil was observed in orbital CT scans.CONCLUSION The timing of silicone oil injection for an eye-penetrating injury should be carefully evaluated to avoid the possibility of silicone oil migration.
文摘Objective: To evaluate the outcome and analyze the methods of surgical treatment of traumatic endophthalmitis following penetrating eye injuries with retained eye foreign bodies. Methods: A total of 62 consecutive cases (58 men, 4 women) from January 1999 to December 2001 with IOFBs following penetrating eye injuries were retrospectively studied. The ages ranged from 8 to 46 years (mean 23 years). Sixty patients (63 eyes) underwent pars plana vitreotomy and 1 patient underwent external magnet extraction. The follow up ranged from 3 to 36 months (mean 12.5 months). Results: Ten eyes developed endophthalmitis, among which 7 ( 10.94 %) were diagnosed preoperatively. The most frequently cultured organism was Staphylococcus epidermis ( 44.44 %, 4/9). Postoperatively, retinal detachment due to vitreoretinal proliferation occurred in 5 patients with endophthalmitis and in 9 patients without endophthalmitis. All the retinal detachments were reattached with additional vitreoretinal surgery. Two eyes with endophthalmitis and two without endophthalmitis were eviscerated. Conclusions: Post traumatic endophthalmitis with intraocular foreign bodies (IOFBs) deserves great attention because of its high incidence and poor prognosis. Vitrectomy is suggested for the treatment of IOFBs and its complications, and it should be performed as soon as possible. Routine intravenous administration of antibiotics combined with periocular injection and topical antibiotics postoperatively are recommended.
基金Supported by the National Natural Science Foundation of China(No.81770934)Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(No.20181810).
文摘AIM:To explore the traumatic endophthalmitis in young children and the outcome of pars plana vitrectomy(PPV).METHODS:Twenty-two eyes of 22 cases of young children consecutive pediatric traumatic endophthalmitis treated and followed up between September 2014 and May 2018 were included.Aqueous humor or vitreous samples were taken for bacterial culture and sensitivity tests.Intravitreal antibiotics(norvancomycin and ceftazidime)injection,combined with 23-gauge PPV,were administered in 22 eyes.Silicone oil(SO;5000 centistoke)tamponade or perfluoropropane gas(C3F8)was used in all patients.Main outcome measures were best-corrected visual acuity(BCVA)and retinal attachment,the ratio of penetrating injury,and the existence of intraocular foreign body.RESULTS:The mean age of patients was 6.9±2.2(range,3-10)y.All injured eyes suffered from penetrating ocular injury with retained intraocular foreign body in one eye.Bacterial culture was positive in only 2 eyes.The mean follow-up time was 21.1±4.7(range,12-30)mo.In the primary PPV,intravitreal antibiotics was administrated in all eyes,SO in 18 eyes,and C3F8 in 4 eyes.The secondary operation of SO removal and C3F8 endotamponade was performed in 16 eyes and a second SO endotamponade due to emulsification of the oil and retinal detachment(RD)was operated in 7 eyes underwent 3 to 11.5 mo after primary PPV.A third operation was done in 7 eyes.The final intraocular pressure(IOP)was 8.9±1.8(range,6.9-11.4)mm Hg.The final BCVAs were 20/200 or better in 5,counting fingers in 2,and light perception to hand movement in 8 eyes.Whose(66.7%)had retinal injury exhibited worse BCVA(P=0.019,Fisher’s exact test).Eyes underwent SO tamponade exhibited worse final BCVA than that with C3F8 in the primary PPV(P=0.026,Fisher’s exact test).CONCLUSION:Traumatic endophthalmitis in children is generally more severe and associated with more complicated surgical procedures.Most patients have retinal injury need multiple operations and the final BCVA is poor.Prevention of ocular trauma,especially in children,is still critical.
文摘A case of retained intralenticular iron piece with signs of mild anterior uveitis at the time of presentation is reported in a 45 year-old man. His vision improved with topical cycloplegics and corticosteroids. After six months, his vision deteriorated grossly due to cataract formation. He regained good vision following removal of foreign body, extracapsular extraction with posterior chamber intraocular lens implantation. This case highlights the conservative management of the condition till the patient develops cataract resulting in visual disability; and good visual recovery following cataract surgery with intraocular lens implantation.
文摘AIM:To report the outcomes of patients undergoing anterior segment optical coherence tomography-guided transepithelial phototherapeutic keratectomy(ASOCT T-PTK)for central corneal scarring after pterygium excision.METHODS:The charts of 11 eyes of 10 patients that underwent ASOCT T-PTK following excision of visual axisinvolving pterygia were retrospectively reviewed from a single private practice institution.The visual outcomes and corneal topographic findings were evaluated 4±1 mo after pterygium excision and 6±2 mo after transepithelial phototherapeutic keratectomy(T-PTK).RESULTS:All 11 eyes tolerated both the pterygium excision and T-PTK procedure well without any significant intraoperative or postoperative complications.Uncorrected distance visual acuity(UDVA)and manifest refraction corrected distance visual acuity(CDVA)improved after pterygium excision(P=0.03 and P=0.05,respectively).The UDVA and CDVA improved further after T-PTK(P=0.004 and P=0.002,respectively).The topographic surface asymmetry index,topographic surface regularity index,and topographic projected visual acuity significantly improved after T-PTK(P=0.0092,P=0.0022,and P=0.0002,respectively).None of the subjects lost any lines of CDVA,developed recurrence of pterygia or required keratoplasty during the postoperative period.CONCLUSION:ASOCT T-PTK can provide excellent visual and anatomic outcomes in patients with central corneal scarring after excision of visual axis-involving pterygia.
文摘Purpose:Given the increased risk of accidents in patients with attention deficit and hyperactivity dis-order(ADHD)or maternal anxiety/depression,we aimed to investigate the frequency of the two diseases in children with penetrating eye injury(PEI).Methods:Altogether 79 children,39 with PEIs and 40 healthy individuals(control group),aged 5-15 years,underwent a complete ophthalmologic examination.Afterwards,schedule for affective disorders and schizophrenia for school-aged children was conducted to assess the psychiatric diagnosis of all children.Turgay diagnostic and statistical manual of mental disorders(DSM-Ⅳ)-based child and adolescent behavior disorders screening and rating scale(T-DSM-Ⅳ-S)was flled by parents to evaluate the severity of ADHD symptoms.The depression and anxiety levels of mothers of each group were evaluated by two self-report measures:the Beck depression scale and the state-trait anxiety inventory(STAI),respectively.Data were analyzed by IBM SPSS version 22.0.The Chi-square and Fisher's exact test were used to determine whether there is a significant difference between qualitative variables while independent sample t and Mann-Whitney U tests to compare quantitative variables.Results:The only diagnostic difference was a significantly higher frequency of ADHD among patients with PEIs(48.7%in PEI vs.17.5%in control group,χ^2=7.359,p=0.007).The total scores of the T-DSM-Ⅳ-S(attention subscale U=418.000,p=0.006;hyperactivity subscale U=472.000,p=0.022)and maternal state-trait anxiety inventory(maternal STAI-state U=243.00,p=0.003;maternal STAl-trait U=298.000,p=0.021)were significantly higher in the PEI group than in control group.In logistic regression,children with PEI had a tendency to have a 3.5-fold increased risk for ADHD(OR=3.538,CI=0.960-13.039,p=0.058).Conclusion:ADHD was detected almost 1 in 2 children with PEls.Besides,the maternal anxiety level was significantly higher in the PEI group than in the control group.This association should be further explored via a future prospective longitudinal study.Since a proper treatment of ADHD in children and anxiety treatment in mothers may prevent vision loss following PEIs in children.
文摘BACKGROUND Intralenticular foreign body is rarely encountered in ophthalmic practice.In most cases,subsequent traumatic cataract requires cataract surgery for visual rehabilitation.CASE SUMMARY A 35-year-old man was injured by iron filings in his left eye.After the injury,the patient tried to draw the object out by himself using a magnet;however,the foreign body(FB)was pushed to the equator of the lens.The FB was removed by a magnet through the anterior chamber accessed through the original capsular wound.Since most of the lens was transparent and only partially opaque after the operation,the lens was kept under close observation.After the surgery,the patient’s visual acuity reached 20/20 from 2/20,visual function recovered very well,and local opacity of the lens remained stable.CONCLUSION For intralenticular FB in the anterior cortex under the capsule,magnet may be a more advantageous way to remove the object.
