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Control of intraocular hemorrhage during vitrectomy
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Intraocular hemorrhage is a common problem during vitreo-retinal surgery. Fortunately, severe bleeding is a rare occur-rence. In a series of 400 consecutive vitrectomies, Peyman et al1 reported a 19% rate of intraoperative hemorrhage. Seventy-five percent of these were controlled with simple measures and the remaining 25% required cautery or diathermy to achieve hemostasis.
Angiostrongylus
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Praphathip Eamsobhana, Hoi-Sen Yong
The larvae usually die shortly after reaching the meninges. Most of the parasites are commonly recovered from the subarachnoid space in autopsy cases. For most of the autopsied cases, the larvae could be seen in histological sections of the brain and spinal cord. They also could often be seen on the surface of the brain or spinal cord. At their death, a local inflammatory reaction ensues. It is manifested by the outpouring of eosinophils in the CSF, and sometimes Charcot-Leyden crystals. In addition, necrosis and granuloma occur around the dying worm [103]. In ocular manifestations, it could cause retinal detachment or intraocular hemorrhage including optic neuritis [83].
Complications in Vitreoretinal Surgery
Published in Pradeep Venkatesh, Handbook of Vitreoretinal Surgery, 2023
Intraocular haemorrhage during vitreoretinal surgery is a serious complication and may result in accumulation of blood in the anterior chamber, vitreous cavity, subretinal space, or choroidal layers [haemorrhagic choroidal detachment] and as a tenacious layering over the retinal surface. The incidence of haemorrhage within the eye during vitreoretinal surgery varies depending on the primary pathology for which the surgery is being performed. While it is relatively very infrequent during surgery for retinal detachment, the same is not true if the indication for surgery is proliferative vascular retinopathies, like diabetic retinopathy. The severity of intraocular haemorrhage may vary from mild to very severe. In addition to immediately compromising the visibility of the anatomical structures and impeding the surgical steps from being carried forward safely, intraocular haemorrhage may also impact the postoperative course and visual outcome. Even if the haemorrhage has been successfully controlled intraoperatively, these patients tend to have a higher incidence of postsurgical inflammation, microscopic to clearly visible hyphaema, corneal staining, fresh bleeding, and early development of PVR or silicone oil emulsification in the postoperative period. The location of intraocular haemorrhage may be the anterior chamber, the root of the iris and anterior chamber angle, layered over the lens or intraocular lens [IOL], between the IOL and the lens capsule, layered along the posterior capsule, confined to the vicinity of the port site, over or under the neurosensory retina, dispersed into the entire vitreous cavity, or within the choroid.
Intraocular Lens Techniques in Pediatric Eyes with Insufficient Capsular Support: Complications and Outcomes
Published in Seminars in Ophthalmology, 2019
Crystal SY Cheung, Deborah K VanderVeen
Newer surgical techniques for scleral fixation of IOLs have been developed to avoid suture-related complications. The use of glued intrascleral fixation of PCIOLs has been described in 41 eyes of 31 children.25 The haptics of either one- or three-piece IOL were externalized under partial-thickness scleral flaps, and these flaps were then closed with fibrin glue (Tisseel; Baxter, Deerfield, Illinois, USA). Two cases (4.8%) of IOL decentration were observed.25 In another study by Kannan et al.,26 intrascleral haptic fixation of three-piece IOL without sutures or glue showed similar outcomes at median follow-up of 12 months (range 12–62 months) in 40 pediatric eyes with ectopia lentis. There was one case (2.5%) of IOL subluxation, and five eyes (12.5%) developed intraocular hemorrhage.26 Overall, the intermediate visual outcomes of intrascleral haptic fixation with or without glue are comparable to those of SF IOLs with sutures. However, these surgical techniques have not been widely reported in children and the long-term outcomes remain unknown.
Posttraumatic Endophthalmitis in children: Epidemiology, Diagnosis, Management, and Prognosis
Published in Seminars in Ophthalmology, 2018
Pooja Bansal, Pradeep Venkatesh, Yograj Sharma
Because of the more virulent kind of infection in the pediatric age group, a prompt PPV should be considered in children with the absence of fundus glow due to vitreous exudation, retained intraocular foreign body, needle or broomstick injury, strong suspicion of fungal etiology, or if there is no response within 24 hours of primary repair and intravitreal injection. This helps in debulking vitreous toxins, microorganisms and inflammatory debris, obtaining intraocular fluid for microbiological testing, as well as better diffusion and absorption of intravitreal antibiotics. If IOFB is present, the eye is usually closed primarily, but a reoperation is scheduled soon afterward to remove IOFB.43,46,47 But this is often made difficult due to significant corneal edema and increased vitreoretinal adhesions, especially at the vitreous base. One may have to debride the corneal epithelium at the start of the surgery to improve visualization. In addition, surgical induction of posterior vitreous detachment is very hard in these young eyes, and so is needle aspiration of the vitreous for obtaining specimens for culture and sensitivity. Also, there is a risk of intraocular hemorrhage intraoperatively if neovascularization of the iris or retina has already set in, depending upon the severity and duration of inflammation.
Odontogenic Lemierre’s syndrome with septic superior ophthalmic vein and cavernous sinus thrombophlebitis complicated by blindness and ophthalmoplegia
Published in Orbit, 2023
Donald Tran, Shivesh Varma, Thomas G. Hardy
Ophthalmic complications are observed in 3.8–5% of LS patients.3,7 Spread of IJV thrombophlebitis can lead to SOV or CS thrombosis, resulting in orbital oedema, chemosis, proptosis, and dysfunction of cranial nerves II–VI.7,14,15 Cranial nerve palsies are common, especially that of the abducens nerve, which is vulnerable in both CS thrombosis and elevated intracranial pressure secondary to cerebral venous sinus thrombosis (‘false localising sign’). Rarer reported manifestations include intraocular haemorrhage and endogenous endophthalmitis.7