Unusual intraocular foreign bodies after an explosion: patient's hand bone fragments.

A 26-year-old Turkish Army soldier underwent full ophthalmoscopic examination after a penetrating ocular injury in the left eye due to the accidental explosion of a detonating fuse during handling. Visual acuity of the left eye was hand motion level. Funduscopy revealed foreign bodies suspended in the vitreous gel and accompanying vitreous haemorrhage. B-scan ultrasonography, CT of the orbits and microscopic examination of the intraocular foreign bodies (IOFBs) were performed prior to removal of bone fragments and pars plana vitrectomy. The IOFBs were fragments of the patients' bone tissue. Bone fragments from victim's body may cause IOFBs after an explosion in military personnel.

Central serous retinal detachment following glaucoma filtration surgery.

We report the occurrence of central serous retinal detachment in association with hypotony in a patient that had undergone glaucoma filtration surgery. A 35-year-old man, who had a recent closed-globe injury, underwent trabeculectomy with mitomycin C for intractable traumatic glaucoma. On the second day after surgery, the eye became hypotonous and the patient's visual acuity decreased abruptly to counting fingers. Fundoscopy and optical coherence tomography revealed a central serous retinal detachment. Fundus florescein angiography showed choroidal leakage from traumatic perifoveal retinal pigment epithelial defects. Although the hypotony resolved within the first postoperative week, it took 2 months for the central serous retinal detachment to clear. To our knowledge, this is the first reported case of isolated central serous retinal detachment following glaucoma filtration surgery.

Evaluation of toxicity of intravitreal ceftazidime, vancomycin, and ganciclovir in a silicone oil-filled eye.

PURPOSE: To evaluate the toxicity of intravitreal drugs in an eye filled with silicone oil for prolonged internal retinal tamponade. METHODS: Vitrectomy was performed in 21 rabbit eyes, and the vitreous was replaced with silicone oil. Different concentrations of various drugs (ceftazidime, vancomycin, and ganciclovir) were injected intravitreally. RESULTS: Silicone oil increased the toxicity of these drugs, which were injected in previously determined nontoxic doses, possibly because of a reduction of the preretinal space. Injecting one quarter of the known nontoxic dose failed to show any toxicity. CONCLUSIONS: Nontoxic concentrations of intravitreal drugs can cause toxicity in a silicone-filled eye.

Use of perfluorocarbon liquids, silicone oil, and 5-fluorouracil in the management of experimental PVR.

PURPOSE: To evaluate the toxicity and efficacy of 5-fluorouracil (5-FU) in combination with perfluoroperhydrophenanthrene (Vitreon), silicone oil, or a combination of silicone oil and Vitreon in a ratio of 3:2 in the management of experimental proliferative vitreoretinopathy (PVR). METHODS: Toxicity study. Seventy rabbit eyes underwent vitrectomy followed by intravitreal injection of 5-FU in doses of 800, 400, or 200 microg: Group 1, 5-FU alone; Group 2, 5-FU plus 1 mL Vitreon; Group 3, 5-FU plus 1 mL silicone oil; Group 4, 5-FU plus 0.6 mL silicone oil and 0.4 mL Vitreon; Group 5, 0.6 mL silicone oil plus 0.4 mL Vitreon. Electroretinography was performed preoperatively and 8 weeks postoperatively before the animals were sacrificed. Efficacy study. Seventy-two rabbit eyes underwent vitrectomy and were injected intravitreally with 100,000-200,000 retinal pigment epithelial cells to induce PVR. Groups were injected with 200 microg 5-FU alone or with 1 mL silicone oil, 1 mL Vitreon, or a combination of 0.6 mL silicone oil and 0.4 mL Vitreon. Others were given only 1 mL Vitreon or 1 mL silicone oil. The animals were followed for 8-12 weeks; PVR was graded using Fastenberg's system. RESULTS: Toxicity study. Eyes given 200 microg 5-FU, silicone, and Vitreon showed mild inflammation and vitritis which resolved in 1 week; the dose was nontoxic by electroretinography and histopathology. Doses of 400 and 800 microg 5-FU were toxic. Efficacy study. Clinical severity of PVR was less in the groups which received 5-FU plus vitreous substitutes when compared to the control groups at all time points. The lowest incidences were in groups given 5-FU plus Vitreon or 5-FU plus Vitreon and silicone oil: 33.33% and 11.11%, respectively. CONCLUSIONS: A dose of 200 microg 5-FU with silicone oil and Vitreon combined was nontoxic to the rabbit retina. The combination of 5-FU, Vitreon, and silicone oil showed significant efficacy in the prevention of experimental PVR.