Cases reported "Eye Injuries"

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1/22. Severe iridodialysis from phacoemulsification tip suction.

    During cataract surgery, the iris of an 83-year-old woman was strongly sucked into the phacoemulsification tip twice, resulting in severe iridodialysis. The dehisced iris was sutured to the sclera using double-armed 10-0 polypropylene on a long curved needle. Intensive suction of the iris by the phacoemulsification tip can lead to severe iridodialysis. Machine setting parameters, particularly flow rate, should be lowered after the first iris suction to avoid further iris damage.
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2/22. Late traumatic wound dehiscence after phacoemulsification.

    Scars from scleral tunnel or clear corneal incisions for phacoemulsification should theoretically be stronger than the larger incisions of planned extracapsular cataract extraction. They should also be more resistant to blunt trauma. We present a case of scleral tunnel wound dehiscence and expulsion of a posterior chamber silicone intraocular lens after blunt trauma.
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keywords = phacoemulsification
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3/22. Intraocular lens subluxation in a patient with facial atopic dermatitis.

    A 66-year-old Japanese man presented with subluxation of a posterior chamber intraocular lens (IOL) caused by a rupture of part of Zinn's zonule but no retinal break 2 years after phacoemulsification with IOL implantation. He had a history of atopic dermatitis since infancy. This case presents a rare ocular complication of scratching and rubbing the face and eyelids because of itching related to atopic dermatitis.
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keywords = phacoemulsification
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4/22. Traumatic wound dehiscence following cataract surgery: a thing of the past?

    PURPOSE: This study compares the frequencies of traumatic wound dehiscence following extracapsular cataract extraction (ECCE) and following phacoemulsification through a self-sealing corneoscleral tunnel. methods: A retrospective review was performed of the surgical record at a British eye hospital from September 1986 to August 1993 and January 1996 to December 1998. Cases requiring surgical repair of wound dehiscence following cataract extraction were identified. The frequencies of traumatic wound dehiscence following ECCE and phacoemulsification were compared using a two by two contingency table (chi-square test). RESULTS: Twenty-one cases of traumatic wound dehiscence were identified following 5,600 ECCEs (0.4%). In 4,200 phacoemulsification procedures only one case of traumatic wound dehiscence was identified (0.02%) (p = 0.0006, OR 15.8, chi2 = 11.69). CONCLUSION: phacoemulsification through a self-sealing corneoscleral tunnel is associated with significantly less risk of traumatic wound dehiscence than is extracapsular cataract extraction. The case of wound rupture following phacoemulsification is discussed with reference to a mechanism for the injury.
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keywords = phacoemulsification
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5/22. iris alteration using mechanical iris retractors.

    A 74-year-old woman had a 3-port pars plana vitrectomy for a dropped nucleus after complicated phacoemulsification. Flexible nylon iris retractors were positioned to dilate the small pupil. The patient died of a pulmonary embolus 1 day after surgery. The eyeball was removed at autopsy, and pathology of the iris was investigated. Localized damage to the iris where the retractor hooks were positioned was noted, but no other alterations to the iris were observed. These findings may explain the recovery of pupil function that is common after surgery with mechanical iris retractors.
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keywords = phacoemulsification
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6/22. Mystery of the vanishing iris.

    We present the first reported case of traumatic aniridia as an isolated injury after blunt trauma to an eye that had phacoemulsification through a corneal tunnel. This case provides insight into the properties of the self-sealing corneal tunnel and possible advantages that it may confer on the eye.
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keywords = phacoemulsification
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7/22. corneal perforation during laser in situ keratomileusis after hyperopic electrothermal keratoplasty.

    PURPOSE: To report a corneal perforation during laser in situ keratomileusis (LASIK) after previous electrothermokeratoplasty. DESIGN: Interventional case report. methods: A 49-year-old man presented with primary hyperopia in the right eye and residual hyperopia after electrothermokeratoplasty in the left eye. His refraction was 4.00 in the right eye and 7.00 -3.00 x 135 degrees in the left eye, with a central pachymetry of 535 microm and 549 microm, respectively. phacoemulsification with intraocular lens (IOL) insertion in the right eye and a two-step keratophacorefractive procedure with a piggyback IOL insertion and LASIK in the left eye were proposed. RESULTS: Postoperative refraction was -0.50 -0.50 x 150 degrees 20/20 in the right eye. Postphacoemulsification refraction was -4.75 -4.25 x 135 degrees in the left eye. Laser in situ keratomileusis was performed in the left eye, 4 months later, with uneventful astigmatic laser ablation. During the myopic ablation, a sudden outcome of aqueous humor in one of the temporal corneal scars was observed. CONCLUSIONS: Unpredictably thin areas after electrothermokeratoplasty may lead to unexpected corneal perforation during LASIK. The available pachymetry systems may be unreliable after electrothermal keratoplasty.
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ranking = 0.16666666666667
keywords = phacoemulsification
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8/22. Expulsion of an intraocular lens through a clear corneal wound.

    A 91-year-old man sustained blunt trauma to an eye that had uneventful phacoemulsification through a superior clear corneal incision 5 years earlier. The silicone foldable intraocular lens (IOL) and a portion of the iris and capsular bag were expulsed through the cataract excision, which then self-sealed. This case illustrates the potential for expulsion of foldable IOLs through small clear corneal incisions even several years after surgery.
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keywords = phacoemulsification
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9/22. Avoiding iris trauma from phacoemulsification in eyes with iridoschisis.

    Iridoschisis is a rare condition frequently associated with age-related cataract. phacoemulsification can be difficult to perform in these eyes, as the detached iris fibrils that are typically present free float in the anterior chamber and are attracted to the phaco tip and the irrigation/aspiration handpiece port. We describe a technique for performing phacoemulsification in eyes with iridoschisis. In this technique, iris fibrils are held in place by 2 ophthalmic viscosurgical devices (OVDs) that are injected into the inferior portion of the anterior chamber. An elliptical capsulorhexis is made and limited to the superior half of the pupil for additional stability of the anterior chamber during surgery. The nucleus is chopped with a phaco chopper and a bent-tip, 22-gauge needle. Most of the phacoemulsification is performed under the anterior capsule. The iris comes into contact with the OVDs only and has no mechanical trauma.
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keywords = phacoemulsification
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10/22. Retinal protection using a viscoadaptive viscoelastic agent during removal of a luxated crystalline lens by intravitreal phacoemulsification.

    PURPOSE: To report a method of retinal protection using a viscoadaptive viscoelastic agent during removal of a luxated crystalline lens by intravitreal phacoemulsification. DESIGN: Interventional case report. methods: A 65-year-old man presented with a totally luxated crystalline lens in the vitreous cavity of the left eye. After total vitrectomy was performed, a viscoadaptive viscoelastic agent was applied over the retina and optic disk. Then the luxated lens was removed by intravitreal phacoemulsification. The lens dropped several times during the surgery but the thick viscoadaptive viscoelastic agent protected the posterior retina. RESULTS: In two cases treated this way, no complications occurred at six months after surgery. CONCLUSION: This method may be useful for protecting the retina from damage by a luxated crystalline lens and is less costly than perfluorocarbon liquid.
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