Endoscopy-assisted vitrectomy for severe ocular penetrating trauma with corneal opacity.

IF 1.9 4区医学 Q2 OPHTHALMOLOGY

International journal of ophthalmology Pub Date : 2024-12-18 eCollection Date: 2024-01-01 DOI:10.18240/ijo.2024.12.14

Yong-Zhen Yu, Liu-Lian Jian, Wen-Xiao Chen, Liang-Hong Peng, Yu-Ping Zou, Long Pang, Xiu-Lan Zou

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Abstract

Aim: To assess the utility and efficiency of endoscopy-assisted vitrectomy (EAV) for the treatment of corneal opacity in severe ocular trauma.

Methods: Patients who underwent fundus examination using a preoperative slit lamp and intraoperative endoscopy, followed by EAV and additional surgery were retrospectively recruited. Silicone oil removal and penetrating keratoplasty were used in selected eyes at postoperative follow-ups. Outcome measurements included the best corrected visual acuity (BCVA), intraocular pressure (IOP), findings of endoscopic fundus examination, and postoperative complications.

Results: Twenty-one eyes with severe ocular trauma and corneal opacity were followed up for 24-36mo. Retinal detachment (RD) and vitreous haemorrhage (VH) were identified in 16 eyes (76.2%), RD only in four eyes (19.0%), and VH combined with intraocular foreign body in one eye (4.8%). All eyes underwent at least three surgeries. Stage-I surgeries involved wound closure (100%), lens extraction (76.2%), and anterior vitrectomy (14.3%). Stage-II surgeries involved scleral buckling (28.6%), membrane peeling (47.6%), retinal laser photocoagulation (100%) and silicone oil tamponade (100%) using EAV. Stage-III surgeries were conducted using endoscopy including silicone oil removal (52.4%), retinal laser photocoagulation (52.4%) and penetrating keratoplasty (28.6%). Nearly all eyes showed improvements in BCVA and IOP. Although there were no severe complications, glaucoma was noted in one eye, chronic hypotony in another eye, and band keratopathy in three eyes.

Conclusion: EAV is an effective adjunct for restoring ocular anatomical structures and visual function in the case of corneal opacity after severe ocular trauma.

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内窥镜辅助玻璃体切除术治疗严重眼穿透性外伤伴角膜混浊。

目的：评价内窥镜辅助玻璃体切除术（EAV）治疗严重眼外伤后角膜混浊的疗效。方法：回顾性招募术前裂隙灯和术中内镜检查眼底，随后行EAV和附加手术的患者。术后随访选用硅油去除和穿透性角膜移植术。结果测量包括最佳矫正视力（BCVA）、眼压（IOP）、眼底内窥镜检查结果和术后并发症。结果：21眼严重眼外伤合并角膜混浊，随访24 ~ 36个月。视网膜脱离（RD）合并玻璃体出血（VH） 16眼（76.2%），RD仅4眼（19.0%），VH合并眼内异物1眼（4.8%）。所有的眼睛都接受了至少三次手术。i期手术包括伤口闭合（100%）、晶状体取出（76.2%）和前玻璃体切除术（14.3%）。ii期手术包括巩膜屈曲（28.6%）、膜剥离（47.6%）、视网膜激光光凝（100%）和硅油填塞（100%）。iii期手术采用内窥镜，包括硅油去除（52.4%）、视网膜激光光凝（52.4%）和穿透性角膜移植术（28.6%）。几乎所有的眼睛BCVA和IOP都有所改善。虽然没有严重的并发症，但一只眼睛出现青光眼，另一只眼睛出现慢性低眼压，三只眼睛出现带状角膜病变。结论：在严重眼外伤后角膜混浊的情况下，EAV是恢复眼解剖结构和视觉功能的有效辅助手段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of ophthalmology Medicine-Ophthalmology

CiteScore

2.50

自引率

7.10%

发文量

3141

审稿时长

4-8 weeks

期刊介绍： · International Journal of Ophthalmology-IJO (English edition) is a global ophthalmological scientific publication and a peer-reviewed open access periodical (ISSN 2222-3959 print, ISSN 2227-4898 online). This journal is sponsored by Chinese Medical Association Xi’an Branch and obtains guidance and support from WHO and ICO (International Council of Ophthalmology). It has been indexed in SCIE, PubMed, PubMed-Central, Chemical Abstracts, Scopus, EMBASE , and DOAJ. IJO JCR IF in 2017 is 1.166. IJO was established in 2008, with editorial office in Xi’an, China. It is a monthly publication. General Scientific Advisors include Prof. Hugh Taylor (President of ICO); Prof.Bruce Spivey (Immediate Past President of ICO); Prof.Mark Tso (Ex-Vice President of ICO) and Prof.Daiming Fan (Academician and Vice President, Chinese Academy of Engineering. International Scientific Advisors include Prof. Serge Resnikoff (WHO Senior Speciatist for Prevention of blindness), Prof. Chi-Chao Chan (National Eye Institute, USA) and Prof. Richard L Abbott (Ex-President of AAO/PAAO) et al. Honorary Editors-in-Chief: Prof. Li-Xin Xie(Academician of Chinese Academy of Engineering/Honorary President of Chinese Ophthalmological Society); Prof. Dennis Lam (President of APAO) and Prof. Xiao-Xin Li (Ex-President of Chinese Ophthalmological Society). Chief Editor: Prof. Xiu-Wen Hu (President of IJO Press). Editors-in-Chief: Prof. Yan-Nian Hui (Ex-Director, Eye Institute of Chinese PLA) and Prof. George Chiou (Founding chief editor of Journal of Ocular Pharmacology & Therapeutics). Associate Editors-in-Chief include: Prof. Ning-Li Wang (President Elect of APAO); Prof. Ke Yao (President of Chinese Ophthalmological Society) ; Prof.William Smiddy (Bascom Palmer Eye instituteUSA) ; Prof.Joel Schuman (President of Association of University Professors of Ophthalmology,USA); Prof.Yizhi Liu (Vice President of Chinese Ophtlalmology Society); Prof.Yu-Sheng Wang (Director of Eye Institute of Chinese PLA); Prof.Ling-Yun Cheng (Director of Ocular Pharmacology, Shiley Eye Center, USA). IJO accepts contributions in English from all over the world. It includes mainly original articles and review articles, both basic and clinical papers. Instruction is Welcome Contribution is Welcome Citation is Welcome Cooperation organization International Council of Ophthalmology(ICO), PubMed, PMC, American Academy of Ophthalmology, Asia-Pacific, Thomson Reuters, The Charlesworth Group, Crossref,Scopus,Publons, DOAJ etc.