Open Globe Injury (OGI) with a Presence of an Intraocular Foreign Body (IOFB)-Epidemiology, Management, and Risk Factors in Long Term Follow-Up.

The purpose of the study was to evaluate visual outcomes and consider management strategies in the eyes with an intraocular foreign body (IOFB). In a single-center, retrospective case-control study, 36 eyes of 36 patients who suffered from open globe injury (OGI) with IOFB were admitted to the Department of Vitreoretinal Surgery of Medical University of Lublin, Poland from January 2015 to December 2020. Most frequent primary procedure was the pars plana vitrectomy (PPV) with IOFB removal (n = 28). Retinal detachment (RD) developed in nine eyes soon after injury or as a further complication. Recurrent retinal detachment occurred in eight of these nine cases. Final VA 0.1 or better was observed in 21 eyes (58%). Fifteen patients had BCVA of less than 0.1. One eye was not included in the final VA assessment due to the short follow-up period. In 25 out of 28 patients who underwent any kind of pars plana vitrectomy (ppV) a BCVA of <0.4 was observed. The prognosis after an IOFB injury is uncertain due to multiple factors in a peri- and postoperative period. Factors predisposing to poor visual outcomes are: IOFB localization in the posterior segment, retinal detachment, vitreous hemorrhage and prolonged silicone oil tamponade.

Pars plana vitrectomy with transscleral fixation of posterior chamber lens in the treatment of post-traumatic lens dislocation.

PURPOSE: To present our experience with post-traumatic lens dislocation management by vitrectomy followed with sutureless artificial lens fixation. METHODS: The retrospective study involved 15 patients (12 men and 3 women) aged from 36 to 78 (on average, 63 years old), from the Vitreoretinal Surgery Teaching Hospital, operated in the years 2013-2015. All cases concerned ocular traumas with dislocation of the natural or artificial lens to the anterior chamber, vitreous body chamber, or post-traumatic aphakia. After vitrectomy, patients had the implant fixated with a technique devised by Scharioth-sutureless fixation of posterior chamber implants in the groove area, with haptics placed in scleral tunnels parallel to the corneal limbus. Preoperative and postoperative condition of the eye was assessed. RESULTS: The average period of observation was 29 weeks. Average pre-surgery refraction was + 10.75, while post-surgery + 1.25. Average best-corrected visual acuity in Snellen charts before surgery was 0.3 and at the end of the observation period 0.5. The improvement in visual acuity after surgery in relation to visual acuity before surgery was statistically significant (P = 0.005). In the first 2 weeks after surgery, minor hypotonia was observed in three of the patients, while in two-moderate bleeding to the vitreous body and the anterior chamber, which subsided without surgical intervention. A slight decentration of the implant observed in two cases did not affect later refraction or BCVA. CONCLUSION: Basing on the abovementioned facts, we believe that this surgical approach facilitates the fixation of the dislocated lens and allows a successful treatment of secondary implantation or repositioning of a dislocated intraocular lens.

Lawn mower injuries as a cause of serious visual acuity impairment - Case reports.

[b]Abstract Objective.[/b] The aim of the study is to present four cases of lawn mowers injuries as a cause of serious visual acuity impairment. [b]Materials and Method[/b]. A retrospective study of four patients admitted in 2013-2015 to the Department of Vitreoretinal Surgery in Lublin with severe open or closed globe injury, one with an intraocular foreign body (IOFB). The presence of eye protective equipment was assessed, as well as visual acuity, eye tissue condition before and after treatment, and applied therapy. RESULTS: In all cases an improvement was achieved in local conditions. The intraocular foreign body was removed, wounds sutured and damaged tissues placed in position. All eyeballs were saved. In three cases, visual acuity was improved to a usable level. Three patients underwent pars plana vitrectomy, one with IOFB removal from the vitreous cavity. [b]Conclusions[/b]. Lawn mower induced eye injuries are a significant cause of serious visual acuity impairment or blindness. The presented study shows that lawn mower eye injuries are still a therapeutic, social and economic problem, yet are very preventable with proper eye protection and patients' education. Current prevention strategies are inadequate, and therefore should be updated.

[Sub-internal limiting membrane haemorrhage--causes, diagnosis and treatment]. / Krwotok pod blona graniczna wewnetrzna siatkówki--przyczyny, diagnostyka i leczenie.

PURPOSE: The purpose of this study was to present cases of patients with massive sub-internal limiting membrane haemorrhage, who were treated with vitrectomy. MATERIAL AND METHODS: We present 2 patients with sub-internal limiting membrane haemorrhages diagnosed clinically, seen in spectral optical coherence tomography and confirmed during vitrectomy with the internal limiting membrane peeling. Visual acuity and clinical manifestation in spectral optical coherence tomography were assessed before and after vitrectomy. RESULTS: The haemorrhage was successfully removed from under the internal limiting membrane in both cases. Visual acuity improved and normal anatomical relationships were restored within the fovea in both patients as well. CONCLUSIONS: Vitrectomy is a safe and effective method, offering fast improvement of visual acuity in patients with massive sub-internal limiting membrane haemorrhage.

[The analysis of morphological and functional macular changes after surgical treatment of idiopathic macular hole--the single centre experience]. / Analiza zmian morfologicznych i czynnosciowych plamki po leczeniu chirurgicznym idiopatycznego otworu plamki--wyniki wlasne.

PURPOSE: to evaluate morphological and functional macular changes after surgical treatment of idiopathic macular hole. MATERIAL AND METHODS: a retrospective study included 25 patients (30 eyes) who underwent surgery for idiopathic macular hole. Male patients constituted 27% and female patients 73% of the study group. Mean age was 67 years. All patients underwent pars plana vitrectomy with internal limiting membrane peeling and gas tamponade (C3F8 or SF6). We evaluated age, sex, best corrected visual acuity as well a optical coherence tomography scans prior to surgery and postoperatively. The mean follow-up was 6 months. RESULTS: the mean preoperative best corrected visual acuity was 0.15 in Snellen charts (≤ 0.1 - 13 eyes, > 0.1 - 17 eyes) and it increased to 0.5 postoperatively. Five eyes were preoperatively classified as stage 2 Gass scale, 13 eyes as stage 3 and 13 eyes as stage 4. Postoperatively, 25 eyes were assorted as "U" shaped and 5 as "V" shape closure. CONCLUSIONS: surgical treatment of macular hole with pars plana vitrectomy significantly improves macular function measured by the best corrected visual acuity. The "U" shaped closure of macular hole promotes better visual outcomes.

[Myelinated nerve fibers coexisted with epiretinal membrane in macula--case report]. / Wlókna rdzenne na tarczy nerwu wzrokowego wspólistniejace z blona przedsiatkówkowa--opis przypadku.

PURPOSE: We describe a case of peripapillary myelinated retinal nerve fibers complicated by epiretinal membrane in region of macula. MATERIAL AND METHODS: 72 years old man was refered to our Clinic with suspicion of retinal detachment of right eye. Visual acuity of right eye was based to 0.05, in left eye was 0.5. IOP was normal in both eyes. In biomcroscopic evaluation the slight cortical cataract was observed in both eyes. Stereoscopic evaluation of right eye revealed the presence of massive peripapillary myelinated retinal nerve fibers and epiretinal membrane in the macula. In the left eye the less intense peripapillary myelinated retinal nerve fibers were noticed as well and the macular region was unchanged. With the use of OCT examination of the retina the presence of epiretinal membrane in the right eye was confirmed. OCT in the fellow eye presented an undisturbed foveal profile without any epiretinal abnormalities. CONCLUSIONS: Myelinated retinal nerve fibers can be complicated by epiretinal membrane. Probably the presence of macular pathologies depends on the extensions of nerve fibers. OCT examination is very helpful to give a proper diagnosis.

Ocular blunt trauma during wood chopping as the reason for serious visual impairments.

AIM: The aim of the study was to present results of blunt ocular trauma with lens luxation to the vitreous during wood chopping. METHODS: A retrospective study of 15 patients treated in the Department of Ophthalmology between 2000-2011 who suffered from serious eye injury during wood chopping. As a standard surgical procedure, pars plana vitrectomy with lens removal and intraocular lens (IOL) implantation was applied in all cases. The analysis includes the age, gender, visual acuity and intraocular pressure before and after surgical procedure, and at the end of follow-up. RESULTS: Mean follow-up was 12 months. The group of patients consisted of 73.3% males (M) and 26.7% females (F). Mean age: 64 years (M - 63 y.o., F - 66.25 y.o.). Mean best corrected visual acuity (BCVA) before treatment: 0.24 on the Snellen chart (< 0.1 - 6 patients, 0.1-0.3 - 5 patients, and > 0.3 - 4 patients). Mean BCVA after surgical treatment: 0.33 (< 0.1 - 4 patients, 0.1-0.3 - 5 patients and > 0.3 - 6 patients). Intraocular pressure (IOP) on the day of admission to hospital varied from 9-52 mmHg (mean - 20.6 mmHg). IOP after surgical procedure: 4-36 mmHg (mean - 20.7 mmHg). SUMMARY: Wood chopping is still present in many homes in rural regions. In some cases, it may lead to serious ocular injury and potential loss of vision.

[Fundus autofluorescence in eyes with dry and wet form of age-related macular degeneration (AMD)--clinical implications]. / Autofluorescencja dna oka w oczach z sucha i wysiekowa postacia zwyrodnienia plamki zwiazanego z wiekiem (AMD)--implikacje kliniczne.

PURPOSE: To evaluate retinal pigment epithelium (FIPE) and photoreceptors layer integrity in different stages of AMO based on fundus autofluorescence imaging and to correlate autofluorescence images with visual acuity. MATERIAL AND METHODS: 322 eyes of 200 patients with different forms and stages of AMD were studied. Mean age was 70 years (49-91 years). Apart from complete ophthalmologic examination patients were examined every 6 months by using a confocal scanning ophthalmoscope HRA2. Follow-up period ranged trom 1 to 40 months (mean--18 months). RESULTS: In 116 eyes with early AMO punctuate changes in autofluorescence images were observed while in 22 eyes (16%) no distinct changes were present. In 52 eyes (62%) with wet AMD normal or near normal autotluorescence signal was present and 34 eyes (38%) with wet AMO had changes in autofluorescence signal corresponding with choroidal neovascularisation (WV) area. In the group of eyes with autofluorescence changes in the CNV area median BCVA was 0.1 and in the group without autofluorescence changes within the CNV area--0.4. All eyes with disciform scar were characterized by uneven autofluorescence signal decrease in scar area with increased signal in surroundig area. Eyes with geographic atrophy (GA) had lack of autofluorescence signal corresponding to RPE atrophy and in 40 cases (95%) increase autofluorescence signal junctional to GA was noted. CONCLUSIONS: Fundus autofluorescence images of the AMO eyes varies greatly. Decrease of autofluorescence signal correlates with visual acuity decrease.