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I.V. Zapuskalov, J.I. Khoroshikh, K.A. Nazarenko, S.V. Valiulina; New Method of Vitrectomy in Primary Surgical Treatment of Severe Corneo–Scleral Wounds . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5514.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To estimate short–term results of primary surgical treatment of severe corneo–scleral wounds. Surgery included a 2–port pars plana vitrectomy with substitution of the vitreous by the sterile air infused into the vitreous cavity under high pressure. Methods: 12 eyes of 12 patients with severe penetrating corneo–scleral wounds were operated using this new method of vitrectomy. In 3 cases trauma was due to pneumatic gun shot; in 4 cases due to knife wound; in 2 cases due to car accident; in 3 cases due to employment injury. After the eye wall defect was closed by suturing, eye pressure was elevated by a physiological salt solution infused into the vitreous until a hypertension was achieved. The two sclerotomies were performed at the opposite from the wound quadrant. Irrigation system was sutured to the first sclerotomy and a sterile air was infused into the eye, to a pressure of 80–90mmHg. Second sclerotomy was used for vitreous cutter. For visualization, an indirect binocular ophthalmoscope was used. Vitrectomy was performed. At the end of procedure the air was replaced by the silicone oil. Results: Using sterile air during vitrectomy reveals overlooked leaking areas, permitting subsequent reliable closure of the scleral wound. The air supplies sharp inter–medium contrast for foreign body detection. Air infusion under high pressure provides best attachment of intraocular structures. Conclusions: This suggested method of vitrectomy in severe corneo–scleral wounds promotes better healing of the eye structures and better functional outcomes.
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