Cases reported "Wounds, Nonpenetrating"

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1/13. 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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2/13. 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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ranking = 0.2
keywords = phacoemulsification
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3/13. 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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4/13. Corneal surgery for severe phacoemulsification burns.

    OBJECTIVE: To evaluate the outcome of corneal surgery for the treatment of severe corneal phacoemulsification burns. DESIGN: Interventional case series. PARTICIPANTS: Four patients with severe intraoperative phacoemulsification burns. INTERVENTION: One patient underwent penetrating keratoplasty and 3 underwent lamellar keratoplasties for the treatment of their corneal burns. MAIN OUTCOME MEASURES: Preoperative and postoperative visual acuities, preoperative and postoperative corneal topographies, and clinical observation. RESULTS: The visual acuity (VA) after the phacoemulsification burn was counting fingers in all patients. One patient had a penetrating keratoplasty, whereas the other 3 had lamellar grafts. After the corneal surgery, the corrected postoperative VA was 20/30 to 20/50 in all patients, with astigmatism ranging from 2.5 to 5.5 diopters. CONCLUSION: Severe phacoemulsification burns can be safely treated with corneal surgery, with acceptable postoperative visual acuities.
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ranking = 1.6
keywords = phacoemulsification
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5/13. New method of surgical repair for 360-degree cyclodialysis.

    A 44-year-old man suffered traumatic 360-degree cyclodialysis in the left eye complicated by persistent hypotony, disc edema, maculopathy, and cataract. Treatment was removal of the cataract with phacoemulsification followed by insertion of a capsular tension ring with 2-point scleral suture fixation with polypropylene in the ciliary sulcus. A foldable acrylic posterior chamber intraocular lens was implanted in the capsular bag through the 4.1 mm corneal tunnel incision. The intraocular pressure responded well with resolution of hypotony, choroidal detachment, disc edema, and maculopathy. Ultrasound biomicroscopy showed complete closure of the cyclodialysis cleft.
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ranking = 0.2
keywords = phacoemulsification
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6/13. 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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7/13. Endocapsular ring approach to the subluxed cataractous lens.

    The surgical management of the cataract associated with extensive zonular dialysis presents a challenge for the anterior segment surgeon. In 1993, a poly(methyl methacrylate) endocapsular ring was introduced to stabilize the capsular bag. We describe the use of this endocapsular ring in phacoemulsification and intraocular lens (IOL) implantation in the capsular bag in four patients with extensive traumatic or congenital zonular dialysis. The endocapsular ring allows expansion and stabilization of the capsular bag to facilitate cortical aspiration and uncomplicated IOL implantation. With follow-up of 4 to 10 months, all IOLs have remained well centered and the patients have had excellent vision free of complications.
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ranking = 0.2
keywords = phacoemulsification
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8/13. 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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9/13. Gentamicin retinal toxicity after cataract surgery in an eye that underwent vitrectomy.

    A cataract developed in a 23-year-old man 4 months after a vitrectomy to repair a traumatic retinal detachment. An uneventful phacoemulsification was performed, using antibiotic-fortified infusion solution. Afterward, a large area of atrophic retina, consistent with gentamicin toxicity, was observed in the macula. The patient remains stable with 20/200 best-corrected acuity. The authors suggest that because the vitreous had been removed, gentamicin was able to settle over the macula during the entire cataract procedure. Therefore, gentamicin should be used intracamerally with caution, especially in eyes in which vitrectomy has been performed.
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ranking = 0.2
keywords = phacoemulsification
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10/13. Posterior capsule rupture by blunt ocular trauma.

    A patient with posterior lens capsule rupture caused by blunt trauma and in whom the anterior capsule and the remainder of the eyeball structure was intact had phacoemulsification and aspiration of the crystalline lens with implantation of a posterior chamber intraocular lens. Further rupture of the capsule was prevented by the fibrosis, which tightened the margin of the ruptured capsule. This case shows that blunt trauma can rupture the posterior lens capsule, leaving the anterior capsule intact.
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ranking = 0.2
keywords = phacoemulsification
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