Cases reported "Surgical Wound Dehiscence"

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1/10. 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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ranking = 1
keywords = phacoemulsification
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2/10. Ultrasound biomicroscopy of chronic hypotony after cataract extraction.

    Ultrasound biomicroscopy was performed with a UBM 840 (Zeiss-Humphrey) equipped with a 50 MHz probe on a patient with chronic hypotony 1 year after cataract surgery by phacoemulsification with intraocular lens implantation in the capsular bag. This sonographic technique, which provides high-resolution imaging of the anterior segment, showed aqueous humor leakage through the former scleral tunnel incision. Ultrasound biomicroscopy helped detect this patient's postoperative complication and is a good tool for diagnostic procedures in patients with chronic hypotony.
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ranking = 0.2
keywords = phacoemulsification
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3/10. 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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ranking = 0.8
keywords = phacoemulsification
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4/10. rupture of a radial keratotomy incision after 11 years during clear corneal phacoemulsification.

    We report a case of rupture of a radial keratotomy (RK) incision that occurred during clear corneal phacoemulsification 11 years after the initial surgery. The RK was done in both eyes for correction of high myopia (>8.0 diopters). This was followed by 2 enhancement procedures at 6 month intervals. The patient presented with diminished vision in both eyes. The diagnosis was nuclear cataract in the right eye, and clear corneal phacoemulsification was done. The intraoperative and postoperative courses were uneventful. Nine months later, clear corneal temporal phacoemulsification was done in the left eye. During surgery, 1 of the radial incisions opened to one third its length. The wound was sutured, and the procedure was completed uneventfully. One month later, best corrected visual acuity was 20/20.
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ranking = 1.4
keywords = phacoemulsification
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5/10. 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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ranking = 0.2
keywords = phacoemulsification
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6/10. Lateral tarsorrhaphy for prevention of postoperative complications resulting from globe luxation.

    We present a case of spontaneous globe luxation and wound dehiscence that developed in a patient with proptosis 1 day after phacoemulsification with posterior chamber intraocular lens implantation. The wound was repaired and a lateral tarsorrhaphy was performed with successful prevention of further luxations. Upon cataract extraction in the patient's other eye, lateral tarsorrhaphy was performed concurrently to prevent operative complications. This report underscores the importance of lateral tarsorrhaphy performed at the time of cataract surgery to avoid postoperative globe luxation with possible wound dehiscence in patients with proptosis or shallow orbits and a history of luxation.
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ranking = 0.2
keywords = phacoemulsification
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7/10. Total iris expulsion through a sutureless cataract incision due to vomiting.

    PURPOSE: To present a case of isolated total iris expulsion through a self-sealing cataract incision 2 weeks postoperatively due to vomiting. methods: Ophthalmological examination included visual acuity assessment, tonometry, slit-lamp examination, fundus ophthalmoscopy and ultrasound examination. RESULTS: A 65-year-old woman experienced sudden visual loss during an episode of vigorous vomiting 2 weeks after uncomplicated phacoemulsification cataract surgery with a sutureless corneal incision. Clinical examination showed a dense anterior chamber haemorrhage. When the blood had cleared, isolated total aniridia was seen. CONCLUSIONS: This is the first reported case of aniridia after cataract surgery due to vomiting.
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ranking = 0.2
keywords = phacoemulsification
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8/10. Ultrasound biomicroscopy in traumatic aniridia 2 years after phacoemulsification.

    A 45-year-old man with retinitis pigmentosa experienced total aniridia in the left eye due to direct blunt trauma 2 years after uneventful bilateral phacoemulsification via a 3.5 mm clear corneal incision. Ultrasound biomicroscopy (UBM) of the left eye revealed no missing or stretched zonular fibers extending from the ciliary body to the anterior capsule, a few iris root remnants, a normal ciliary body, an in-the-bag acrylic intraocular lens, and Descemet's membrane dehiscence at the corneal tunnel through which the iris extruded. The eye recovered 20/25 visual acuity after 1 week. Transient hyphema and a rise in intraocular pressure were recorded. This is the first report of traumatic aniridia 2 years after phacoemulsification with UBM evidence of undamaged zonular apparatus. A UBM examination may be clinically helpful, especially when blood prevents accurate slitlamp examination of the anterior segment.
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ranking = 1.2
keywords = phacoemulsification
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9/10. Postoperative blunt trauma to 7.5 mm scleral pocket wounds.

    Two patients received blunt trauma to the operated eye after phacoemulsification cataract surgery. Both patients had a three-step 7.5 mm chord width, 3.0 mm long, curving incision, extending from sclera into clear cornea. One patient had rupture of the scleral tunnel and horizontal suture 20 days after surgery. The intraocular lens was dislocated into and along the scleral tunnel. The second patient had direct trauma four days after surgery, resulting in cheese-wiring of the horizontal nylon 10-0 suture and wound leakage but no other sequelae. Blunt trauma after scleral pocket phacoemulsification cataract surgery may result in clinical wound dehiscence if sufficient force is sustained.
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ranking = 0.4
keywords = phacoemulsification
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10/10. Expulsive iridodialysis: an isolated injury after phacoemulsification.

    I report a case of blunt trauma to an eye that had had uneventful phacoemulsification through a 5.0 mm self-sealing corneoscleral incision 4 months earlier. Total iris expulsion occurred through the cataract incision without extension of the wound or disruption of the posterior capsule or intraocular lens. A possible mechanism for this injury is discussed and related to the unique properties of the corneoscleral incision.
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ranking = 1
keywords = phacoemulsification
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