1/98. Repair of orbital floor fractures with hydroxyapatite block scaffolding.PURPOSE: To determine the efficacy of using a scaffold of hydroxyapatite blocks within the maxillary sinus to treat patients with large orbital floor fractures and secondary vertical globe dystopia. methods: Case series of five patients. Hydroxyapatite blocks were stacked within the maxillary antrum to support the reconstructed orbital floor. RESULTS: All patients had good results, though mild residual enophthalmos persisted in three patients. The orbital floor implants and globe positions remained stable during follow-up intervals ranging from 46 to 65 months. No adverse postoperative complications, such as sinusitis, developed. CONCLUSIONS: Hydroxyapatite block scaffolding is a useful alternative to metallic floor implants and autologous bone grafts in the reconstruction of large traumatic orbital floor defects associated with vertical globe dystopia.- - - - - - - - - - ranking = 1keywords = plant (Clic here for more details about this article) |
2/98. An unusual complication of retinal reattachment surgery.The authors report a case with an unusual late extraocular complication of scleral buckling and local silicone sponge implant. Four years after the reattachment surgery, a ptotic upper eyelid perforated by local silicone sponge implant and fistula between upper eyelid and sclera were detected. Primary repair of upper eyelid and removal of silicone sponge were performed. One year later, the retina was attached and there was no problem with the upper eyelid. cryotherapy, episcleral explant (scleral buckling), and local implant (sponge) are frequently used and effective methods for retinal reattachment surgery. Postoperative early and late complications have been reported. To our knowledge, there is no report of upper eyelid perforation, ptosis and fistula formation caused by silicone sponge implant rejection.- - - - - - - - - - ranking = 2.5keywords = plant (Clic here for more details about this article) |
3/98. Posterior chamber intraocular lens dislocation with the bag.We report a rare case of a 46-year-old man presenting with a luxation of a posterior chamber intraocular lens (IOL) with the capsular bag after ocular contusion. Preoperative axial length was 36.58 mm. After trauma, pars plana extraction of the dislocated IOL inside the capsular bag was performed using a forceps. Capsular fibrosis had probably weakened the zonules, which were ruptured by the trauma. This observation confirms the necessity of a large continuous curvilinear capsulotomy and meticulous cleaning of the anterior and posterior capsules to minimize postsurgical fibrosis and capsule contraction.- - - - - - - - - - ranking = 5.8416619758597keywords = capsule (Clic here for more details about this article) |
4/98. Traumatic cataract presenting with unilateral nasal hemianopsia.A 56-year-old man developed a nasal field defect in his left eye 3 months after a traumatic accident. An examination showed a posterior subcapsular cataract in the left eye with no neurologic deficits. Humphrey 24-2 visual field testing revealed a nasal hemianopsia in the left eye. After cataract extraction and intraocular lens implantation, the patient's visual field returned to normal. This case shows that a cataract can present with a localized visual field deficit, which may be corrected by cataract extraction.- - - - - - - - - - ranking = 0.5keywords = plant (Clic here for more details about this article) |
5/98. A technique for repair of iridodialysis in children.Iridodialysis can occur with blunt or penetrating trauma or inadvertently during intraocular surgery. A small dialysis may not need treatment. A larger iridodialysis that causes polycoria and diplopia, or a grossly eccentric pupil, needs to be reapproximated. A number of surgical techniques for repair, using double-armed polypropylene suture, have been reported. The suture is either left external on the surface of the sclera with the knot buried, covered with a triangular scleral flap, or retrieved with special forceps and buried in a scleral "groove." These techniques have also been used to allow posterior fixation of intraocular lens implants in the absence of capsular support; a complication of this approach is suture erosion through sclera, conjunctiva, or both. The pediatric sclera is softer and more elastic than adult sclera, and surgical repairs must last for decades. Concern about late suture erosion, and a desire for minimal scleral manipulation, led me to develop a simple technique for iridodialysis repair using a scleral tunnel incision and double-armed 10-0 polypropylene suture.- - - - - - - - - - ranking = 0.5keywords = plant (Clic here for more details about this article) |
6/98. Late traumatic intraocular lens extrusion after penetrating keratoplasty.BACKGROUND: Penetrating keratoplasty places a patient at risk for wound rupture from blunt trauma because the graft-host interface remains weakened for years after the surgery. Violent environments, contact sports, and strenuous activity put patients with compromised corneal structural integrity at high risk of traumatic injury. CASE REPORT: This case report presents a 42-year-old penetrating keratoplasty patient with a history of homelessness, polysubstance abuse, and domestic violence. This patient experienced a ruptured globe at the graft-host junction secondary to a direct blow by a fist, which extruded the intraocular lens from the eye. After emergency wound closure, the graft continued to degrade until bullous keratopathy developed. With little visual recovery potential for this graft, a Gunderson conjunctival flap procedure was implemented to decrease chronic ocular pain. CONCLUSIONS: After penetrating keratoplasty, patients should be periodically reminded of the susceptibility of the graft wound to injury from high-risk activity and violence. Constant use of protective eyewear should be recommended to corneal transplant recipients.- - - - - - - - - - ranking = 0.5keywords = plant (Clic here for more details about this article) |
7/98. Chronic, traumatic intraconal hematic cyst of the orbit removed through the fronto-orbital approach--case report.A 22-year-old male presented with a chronic encapsulated intraorbital hematoma 3 months after blunt trauma to his left eyeball. Ophthalmological examination found the best corrected visual acuity was 4/20 in the left eye, and 20/20 in the right eye. The orbit exhibited exophthalmus and inability of the eye to move above the horizontal level. Orbital magnetic resonance imaging showed a fairly well-demarcated area in the medial aspect of the orbit appearing as hyperintense on T1-weighted images and isoto hyperintense on T2-weighted images. This area was believed to be hemorrhage. No other abnormalities were found. The diagnosis was hematic cyst. The cyst was approached through a left fronto-orbital route and its location identified within the periorbita and orbital fat. The cyst was removed partially. Histological examination demonstrated cystic accumulation of blood and breakdown products in a non-epithelium-lined fibrous capsule, compatible with hematic cyst. The presence of hemosiderin in the cyst wall suggested that the cyst was a chronically enlarging lesion. Hematic cysts of the orbit usually present as subperiosteal mass months to years after trauma. Surgical removal of the cyst wall rather than needle aspiration is recommended to prevent recurrence.- - - - - - - - - - ranking = 2.9208309879299keywords = capsule (Clic here for more details about this article) |
8/98. Traumatic endophthalmitis caused by an erwinia species.A previously healthy 70-year-old white man sustained a plant injury to his left eye while gardening and was admitted here because of an ensuing perforated cornea and endophthalmitis. The lens was opaque and its anterior capsule was ruptured. culture of fluid obtained by anterior chamber paracentesis yielded a species of the erwinia herbicolalathyri group (enterobacter agglomerans). Thirty-seven days after a course of cefazolin and gentamicin therapy, corneal edema necessitated a planned extracapsular cataract extraction. The aqueous humor and lens again revealed the identical erwinia species in pure culture. The patient received another course of cefazolin and showed improvement after the lens aspiration.- - - - - - - - - - ranking = 3.4208309879299keywords = capsule, plant (Clic here for more details about this article) |
9/98. Epilenticular intraocular lens implantation in traumatic cataract with a ruptured posterior capsule.PURPOSE: To present a case of rapidly progressing traumatic cataract caused by posterior capsule rupture after nonpenetrating ocular injury, as well as a surgical procedure to safely implant the intraocular lens in such a traumatized eye. methods: In a 23-year-old man with traumatic cataract and posterior lens capsule rupture, a one-piece polymethylmethacrylate IOL was implanted before cataract extraction into the ciliary sulcus in front of the cataractous lens. Subsequently, the cataract was removed by pars plana lensectomy. RESULTS: The surgery and postoperative course were uneventful. Postoperative visual acuity was 20/20. CONCLUSION: We present a method of intraocular lens implantation in cases of rapidly progressing traumatic cataract caused by posterior capsule rupture after a blunt ocular trauma.- - - - - - - - - - ranking = 23.945816915509keywords = capsule, plant (Clic here for more details about this article) |
10/98. Posterior capsule rupture after a paint-pellet injury.We report a case in which a high-velocity paint pellet injury to the eye ruptured the posterior lens capsule. In the setting of blunt trauma, posterior capsule rupture has rarely been reported. Recognizing such a rupture allows the surgeon to plan the best surgical approach.- - - - - - - - - - ranking = 17.524985927579keywords = capsule (Clic here for more details about this article) |
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