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The challenging surgical road to vision improvement - a penetrating ocular trauma case

Poster Details

First Author: R.Couceiro PORTUGAL

Co Author(s):    H. Proenca   M. Monteiro-Grillo           

Abstract Details

Purpose:

To report a case of penetrating ocular injury complicated with aphakia, trauma to the iris and retinal detachment, and to describe the persistent surgical efforts undertaken to recover visual acuity.

Setting:

Teaching hospital, terciary referral centre.

Methods:

A 27 year-old male suffered a penetrating ocular injury to his left eye in a work accident with a knife. Visual acuity in the injured eye was light perception. On examination we noted a corneoscleral full-thickness central laceration, traumatic iridectomy and aphakia of the left eye. Fundoscopy revealed vitreous hemorrhage and a superior retinal detachment (RD). The corneoscleral wound was sutured in the emergency operating room. Four days later the patient was submitted to RD surgical treatment (vitrectomy 23G, endolaser and C3F8 tamponade). In the postoperative period he developed papilitis and cystoid macular edema and neovessels were noted along the corneal scar. Both these complications were managed with medical therapy (topical and systemic steroids). Surgical iridoplasty and iris-claw intraocular lens placement were performed four months after the inicial injury. Final best corrected visual acuity of the left eye was 20/32.

Results:

Penetrating trauma to the eye can have devastating consequences to its structure and visual function. On an immediate basis, the risk of infection determines the need for wound closure. Surgical structural reconstruction may then be undertaken, but this may involve a challenging step wise surgical approach. A good visual outcome can be achieved after penetrating trauma, however one must be aware of possible post-operative complications, in order to avoid them and manage them in useful time.

Conclusions:

-

Financial Disclosure:

NONE

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