Jornal de Oftalmologia Clínica e Experimental
Acesso livre

Abstrato

The Reliability of Anterior-Posterior Segment Integrative Surgery via Sclera Tunnel Incision to Intraocular Foreign Bodies

Jundong Zhu, Haiyan Wang, Lilian Xie, Yuyu Xie, Zhiyuan Li

Objective: To evaluate the feasible, effective procedures in the traumatic cataract extraction,through23-gauge (G)Pars Plana Vitrectomy (PPV) and one-step removal of posterior segment intraocular foreign bodies (IOFBs) via scleral tunnel incision.

Methods: This is a retrospective case-series study, 30 eyes of 30 patients with penetrating corneal injury with traumatic cataract and posterior segment IOFBs from January 2015 to January 2021 at the People’s No.1 Hospital of Chenzhou and the Changsha Aier Eye Hospital were enrolled. After traumatic cataract extraction and 23G PPV treatments, intravitreal foreign body tweezers were used to extend the anterior chamber into the vitreous cavity from the 12-point scleral tunnel incision and the posterior segment foreign body was clamped. The routine follow-up as 1,2 weeks and 1,3,6 and 12 months after surgery. The Best Corrected Visual Acuity (BCVA), Intraocular Pressure (IOP) and retinal conditions were recorded.

Results: Among the 30 patients, 29 were male and 1 female, the follow-up time is (9.57 ± 1.94) months. 17 cases were intravitreal foreign bodies, 11 cases were extra retinal macular foreign bodies and 2 cases were intraretinal macular foreign bodies. All posterior segment IOFBs were one-step removed through the scleral tunnel incision, without the need for the delayed removal or the need for 23-gauge scleral puncture through enlarged the incision. The final BCVA improved for 25 eyes (83.33%), the BCVA unchanged for 4 eyes (13.33%), and the BCVA decreased by 1 eye (3.33%) (t final vs. OP at vitreous=0.0372 **p<0.01; t final vs. OP at retinal=0.0627 *p<0.05). No scleral puncture associated complications. One patient had Retinal Detachment (RD).

Conclusion: The Traumatic cataract extraction, 23-gauge PPV and one-step removal of the posterior segment IOFBs via a mini-puncture scleral tunnel incision, are feasible and effective in treating the posterior segment IOFBs combined with traumatic cataract, which benefits to reduce scleral complications and improve the BCVAs.