Eyeball Atrophy Research Articles

The clinical effects of wearing thin-walled ocular prosthesis after conjunctival flap covering surgery

Objective To study the clinical effects of wearing thin-walled ocular prosthesis after conjunctival flap covering surgery in treatment of atrophy of eyeball.Methods 30 patients (30 atrophied eyes) were accepted the lamellar keratectomy combined with conjunctival flap covering surgery.A temporary ocular conformer was inserted at the completion of the procedure and was worn until the patients received a thin-walled ocular prosthesis 2 to 3 weeks after surgery.Results No complications such as conjunctival fallback or infection occured in the follow-up of 2 to 4 months.30 patients worn thin-walled ocular prosthesis,they were satisfied with the cosmetic effect.Conclusion The thin-walled ocular prosthesis can provide good cosmetic effect,so it is appropriate for the atrophied eyes which were taken lamellar keractectomy and conjunctival flap covering surgery. Key words: Ocular prosthesis; Covering, conjunctival flap ; Atrophy of eyeball

Prognostic factors in severely traumatized eyes managed with vitrectomy

Objective To explore the prognostic factors of functional outcome in severely traumatized eyes managed with vitrectomy.Methods 130 eyes of 116 cases with severe trauma were retrospectively analyzed to determine the factors in predicting functional outcome after vitrectomy.The potential factors were confirmed in univariate analyses and the statistical significant indicators were tested by nonconditional logistic regression mode for multivariate analysis.Results Atrophy of eyeball occurred in 29 eyes after surgery.The rest eyes had normal contour.The short-term efficant rate was 77.6％.These potential prognostic indicators included prolapse of intraocular contents into anterior chamber,vitreous hemorrhage,retinal damage,retinal detachment,multiple wounds,preoperative infection,time interval between injury and operation.Based on the logistic regression mode results,the prognostic indictors for poor visual outcome were found to be prolapse of total intraocular contents,anterior chamber and vitreous hemorrhage,retinal damage more than 90％,multiple wounds and preoperative infection.Conclusion Poor predictors of visual outcome for severely traumatized eyes managed with vitrectomy were prolapse of total intraocular contents,anterior chamber and vitreous hemorrhage,retinal damage more than 90％,multiple wounds and preoperative infection. Key words: Vitrectomy; Trauma,ocular; Efficacy; Indicator

Vitrectomy for complicated intraocular foreign body

Objective To evaluate the clinical effects of vitrectomy for complicated intraocular foreign body.Method Clinical data of 118 cases (118 eyes) with complicated intraocular foreign bodies treated with pars plana vitrectomy were analyzed retrospectively,the results of operations were summarized.Results The foreign bodies of 116 cases were successfully removed(98.3％).Visual acuity improved in 98 eyes (83.0％),remained unchanged in 12 eyes (10.2％) and decreased in 8 eyes (6.8％) ;92 cases had accepted retinal laser photocoagulation (80％) ; 68 cases (57.6％) had accepted silicone oil tamponade ;8 cases (6.8％) had undergone intraocular lens implantation.Postoperative complications included retinal detachment in 9 eyes(7.6％) ;secondary elevation of intraocular pressure in 26 eyes(22.0％) ; and eyeball atrophy in 2 eyes (1.7％).Conclusion Vitrectomy in the treatment of complicated ocular trauma with intraocular foreign body has clinical advantages.The time of the operation,the design of surgical procedures and postoperative complications palyed important roles in the success of the surgery. Key words: Vitrectomy ; Intraocular foreign body

Surgical treatment of infectious endophthalmitis

Objective To study the etiology,pathogen,treatment and prognosis of infectious endophthalmitis.Methods 12 cases (12 eyes) with infectious endophthalmitis were retrospectively studied.Data collected including gender,age,physical injury,etiology,treatment and results were analyzed.Restlts In 12 patients,1 case underwent enucleation,1 case progressed to eyeball atrophy after conservative treatment,10 cases underwent vitrectomy surgery.Among patients underwent vitrectomy surgery,1 case of huge introcular foreign body was not removed and gradually progressed to eyeball atrophy during follow-up,1 case of fungal endophthalmitis relapsed during follow-up and gradually progressed to eyeball atrophy.The remaining 8 cases were retained the eye,and the corrected visual acuity ranged from light perception to 0.3.One case was detected subspecies of staphylococcus schleiferi from purulent vitreous culture,2 cases were detected aspergillus,7 ocular fluid samples showed negative growth on culture,2 cases did not send vitreous culture pus.Conclusion For patients confirmed or with highly suspected endophthalmaitis without relief under introvitreal injection of drugs and systematic antibiotics application,timely vitrectomy may be suitable to retain the eyeball and save part of vision. Key words: Endophthalmitis, infectious; Foreign body, intraocular; Vitrectomy; Prognosis.

Clinical analysis of implantation of allogeneic sclera in operations of the external eye repair in 35 cases

Objective To assess the clinical effect of implantation of allogeneic sclera in operations of the external eye repair.Methods Allogeneic sclera was used for eyelid reconstruction,Hydroxyapatite ceramics implantation and early expose,correction ptosis,treating minor degree eyeball atrophy etc in 35 case.The effect was observed.Results There was no rejection and had a full function.and external appearance improved in all case.Conclusion Allogeneic sclera is easy to gain and simply preserved ; it should be used widely in the external eye repair. Key words: Allogeneic, scleral transplantation; Operations of repair, external eye

Clinical features of ankylosing spondylitis associated with acute anterior uveitis in Chinese patients.

To characterize the clinical features, diagnosis, treatment and prognosis of uveitis associated with ankylosing spondylitis (AS) in Chinese patients. Two hundred and three patients with uveitis associated with AS followed-up in the Third Military Medical University Daping Hospital between 2005 and 2010 were retrospectively evaluated in this study. Complete ophthalmological examinations were evaluated at baseline and during the follow-up period. The gender, age, follow-up time, mean frequency of uveitis onset, and accompanying eye examination findings, history, demographical parameters were reviewed. All the patients presented complete clinical and radiologic (sacroiliac, lumbar, dorsal and cervical spine, knee, ankle, shoulder, hip, elbow) evaluation. HLA-B27 typing was also searched. There were 203 patients diagnosed with AS associated uveitis. All showed sacroiliac X-ray changes indicative of AS. There were 184 male and 19 female patients. The average age of patients was 35±12 (range 18-50). Mean follow-up period was 2.4 years (1-5 years). Acute anterior uveitis was the most common type of uveitis in both genders. 121 eyes presented unilateral involvement (55.2%), and 92 eyes presented bilateral involvement (45.3%) with onset alternately. 22 eyes occurred hypopyon, 16 eyes were found anterior vitreous cells, 7 eyes were noted reactive macular edema or exudation, 29 eyes presented posterior synechiae of iris, and 14 eyes presented cataract, 9 eyes presented secondary glaucoma, 2 eyes presented bend corneal degeneration and 1 eyes presented atrophy of eyeball. At the final visit, uveitis was well controlled in most patients. AS associated with uveitis in Chinese patients mainly manifests as acute anterior uveitis. A combination of corticosteroids with other mydriasis agents is effective for most AS associated with uveitis patients. In general, the prognosis is good in these cases.

Clinical evaluation of extraction of giant intraocular foreign body via anterior chamber combined with vitreoretinal surgery

Objective To evaluate the effect of extraction of giant intraocular foreign body (IOFB)via anterior chamber combined with lensectomy and vitreoretinal surgery. Methods 59 cases (59 eyes) with giant intraocular foreign body at the posterior segment of eyeball were studied for retrospective analysis. Firstly lentectomy and vitrectomy were done, then the IOFB was transferred into anterior chamber by foreignbody claw,and the IOFB was extracted throug limbus intision. Follow up survey was in 3-30 months. Results All giant intraocular foreign body extraction was perfromed successfully once in all the 59 eyes. The corrected visual acuity was greater than 0.05 in 35 eyes ( 59.4% ), less than 0.05 in 24 eyes ( 40.6% ), 3 eyes (5.08%) ( the diameter of FB ≥ 10 mm) among the 24 eyes showed eyeball atrophy. Conclusions The extraction of IOFB via limbus incision combined with lentectomy and vitrectomy was a safe and effective choice which was helpful to reduce serious complications. Key words: giant foreign body; anterion chamber; vitreoretinal surgery

Clinical effects of the implantation of hydroxyapatite orbit after scleral flap

Objective To investigate the clinical outcomes on implantation of hydroxyapatite orbit after scleral flap especially in the cosmetic results. Methods Implant hydroxyapatite orbital after scleral flap for the treatment of all kinds of patients who should be enucleated, including 14 cases of eyeball atrophy, 5 cases of sclerocorneal staphyloma, 3 cases of absolute glaucoma, 3 cases of neovas cular glaucoma and 7 cases of eyeball rupture. Results We observed that the orbit was full and the orbital movement was smooth in all cases. After 3 to 12 months follow up we found that no hydroxyapatite exposed or moved. Conclusion Good cosmetic results can be achieved by the implantation of hydroxyapatite orbit after seleral flap. Key words: Hydroxyapatite orbit; Scleral flap; Eye enucleation

Pars plana vitrectomy on the patients with corneal opacity

目的 探讨眼外伤角膜浑浊状态下玻璃体视网膜手术的手术时机、方法及技巧.方法 对65例(67眼)眼外伤角膜浑浊(≥2/5面积)术中采用刮除角膜上皮、应用棱镜式接触镜、转动眼位及头位、巩膜外顶压及临时人工角膜等不同的手术方法和技巧,完成玻璃体视网膜手术.结果 本组67眼全部顺利完成手术中各项操作,其中9眼眼内异物均在直视下摘出.术后有13眼(19.40%)视网膜脱离,其中6眼再次手术成功,7眼放弃手术.随访6～12个月,最终视力≥眼前数指者39眼(58.21%),眼球萎缩9眼(13.43%).同时行穿透性角膜移植3眼,2眼植片透明,1眼植片浑浊.结论 眼外伤角膜浑浊状态下,应尽量采取相应措施完成玻璃体视网膜手术,以挽救视功能或保留眼球。

The reason and pathological analysis of 146 patients with enucleation of eyeball.

目的 分析摘除眼球的病理学分类以进一步探讨眼球摘除的原因.方法 对本院2001年1月～2007年8月病理室存档的146例眼球摘除病例进行临床分析及组织病理学分析,并分析临床诊断与病理诊断是否相符合.结果 眼内肿瘤107例,占分析病例的73.29%,包括:视网膜母细胞瘤59例,脉络膜黑色素瘤28例,其它肿瘤20例.除肿瘤外尚有:感染性眼内炎9例;眼球萎缩8例,其中外伤性眼球萎缩7例,巩膜炎致眼球萎缩1例;眼球破裂伤5例;角巩膜葡萄肿5例;Coats病2例;其它10例,共占分析病例的26.71%.临床诊断与病理学诊断相符者135例,占92.47%.结论 眼内肿瘤是眼球摘除的首要原因,最多见于儿童的视网膜母细胞瘤,其次是成人的脉络膜黑色素瘤,这是眼球摘除两大重要的原因。

Analysis of effect on treatment of fungal endophthalmitis by vitrectomy combined with intraocular drug injection

目的 探讨玻璃体切除联合眼内注药治疗外源性真菌性眼内炎的远期疗效.方法 对13例(13眼)外源性真菌性眼内炎采取玻璃体切除联合眼内注药治疗,随访1～2年,观察疗效.结果 13眼中有6眼保存有用视力,眼前数指～手动者2眼,光感者1眼,眼球萎缩者2眼,2眼因术后疼痛行眼内容物摘出.结论 真菌性眼内炎的预后不佳.早期行玻璃体切除联合眼内注药,可拯救部分视力,是目前治疗真菌性眼内炎有效方法。

Prognosis of traumatic eyes with no light perception undergone vitrectomy and analysis of risk factors

To evaluate the prognosis of traumatic eyes with no light perception post vitrectomy, and to analyze the risk factors influencing the final results. Five hundred and ninety nine mechanically injured eyes in 577 patients undergone vitrectomy were registered from 1999 - 2004. Thirty-eight eyes in this group showed no light perception in initial visual examination. Thirty-two eyes (84.2%) had open-globe injury, the other 6 eyes (15.8%) had closed-globe injury. Excluded the enucleated eyes, the others were followed up for at least 6 months, averaged 7.2 months. All registered data were filled in predesigned forms. Each parameter was evaluated strictly according to the standards of the protocol. The risk factors of poor prognosis and traumatic no light perception were analyzed by logistic regression. Fourteen eyes (36.8%) achieved anatomic and functional success. Three eyes (7.9%) attained anatomic success. Nine eyes (23.7%) were enucleated. Hypotony occurred in 4 eyes. Seven eyes were maintained by silicone oil. Atrophy of eyeball occurred in 1 eye. Twenty-one eyes (55.3%) achieved a final visual acuity of light perception or better, including: 0.2 in 3 eyes, 0.02 in 2 eyes, count finger in 3 eyes, hand move in 3 eyes, light perception in 10 eyes. Eight eyes (21.1%) remained no light perception. The logistic regression analysis identified the significant risk factors predictive of poor prognosis, including traumatic no light perception, presence of a relative afferent pupillary defect (RAPD), massive suprachoroid hemorrhage (MSCH), panretinal detachment with closed-funnel, ciliary body injury, preoperative atrophy of eyeball, prolapse of iris and aniridia, extrusion of crystalline lens, length of scleral wound greater than 10 mm and ruptured injury. These factors were also the risk factors of traumatic no light perception, excluded traumatic no light perception, prolapse of iris and aniridia. More than one risk factor usually co-exists in each eye. The eyes with traumatic no light perception have poor prognosis. However, 45% of them can achieve functional and anatomic success undergone vitrectomy. Eyes with no light perception are related to the combination of various risk factors. MSCH, severe retinal injury and extensive ciliary body injury are the main risk factors for poor prognosis.

Clinical observation of vitreoretinal surgery for early atrophy of eyeball after trauma

目的 评价玻璃体视网膜手术治疗外伤后早期眼球萎缩的临床效果.方法 回顾性分析43例(43眼)外伤后早期眼球萎缩的临床资料,均行玻璃体视网膜手术联合硅油填充治疗,术后平均随访10.3月,可取出硅油的患者在硅油取出术后再随访,考察术眼视力、眼轴、眼压和眼底的情况.结果 43眼中视力提高者29眼(67.44%).27眼(62.79%)眼球萎缩得到控制,视网膜平伏.7眼(16.27%)硅油取出后眼球继续萎缩.3眼(6.98%)眼底基本平整,但眼压＜5 mmHg.4眼(9.30%)因眼底情况差,硅油未予取出.2眼(4.65%)放弃治疗.结论 玻璃体视网膜手术是治疗外伤后早期眼球萎缩的有效途径,大部分患者眼球萎缩可以控制,眼球外形得以保持,部分患者视力可以提高。

An investigation on the treatment for neovascular glaucoma

目的 探讨晚期新生血管性青光眼的手术治疗方法.方法 对14例(14眼)晚期新生血管性青光眼施行全视网膜冷凝联合睫状体冷凝和部分小梁切除术.结果 本组病例随访6～24月,平均15月,眼压均控制良好,视力术后有所提高或保持不变,无眼球萎缩发生,主要并发症为眼睑水肿、球结膜水肿和前房纤维素性渗出等.结论 该术式是治疗晚期新生血管性青光眼有效、安全、可行的术式。

High-dose steroid therapy of traumatic optic neuropathy may fail to protect the optic nerve permanently

Background: The optimal treatment of traumatic optic neuropathy (TON) is still unresolved due to the poor understanding of the pathology involved and the relatively small number of cases in the published clinical series. It is currently held that the results of conservative treatment with high-dose corticosteroids are similar to those obtained with surgical decompression. Purpose: To assess the late results of conservative treatment for traumatic optic neuropathy. Patients and methods: 15 patients (3 women and 12 men, age 14–64 years) who sustained a direct injury to the optic nerve as a consequence of closed head trauma. All were treated conservatively with high-dose dexamethasone therapy. Ten patients presented for follow-up examination 3–11 years after the injury, on average 5.3±2.4 years (SD). A full ophthalmologic examination and color-coded Doppler (CCD) study of the orbital vessels was performed in all subjects. Results: Full blindness of the affected eye, persisting since the injury, was noted in six patients. Their visual acuity did not improve in spite of vigorous treatment and their eyes remained without sight at the follow-up examination. The finding of an absence of flow in central retinal arteries at follow-up suggests structural damage to the nerve. Moreover, in five of these patients, distinct features of eyeball atrophy had evolved between the time of injury and the follow-up examination. Four patients, who on admission presented only with the ability to perceive light, responded to 2–3 weeks of steroid therapy with improvement of visual acuity to 3/50, 5/50, 5/10, and 5/7. After 4–6 years, however, the visual acuity of all of these patients had deteriorated, resulting in nearly total blindness in one case, light perception in two, and 1/50 in the fourth. Optic nerve atrophy was diagnosed in all of the affected eyes. Conclusion: Conservative treatment of TON, even if giving transient improvement in visual function, may not be reliable in providing permanent relief from the sequelae of traumatic optic neuropathy.