This report is based on a statistical analysis of the records of 116 cases of perforating eye injuries among 39,721 patients who visited the eye department of the National Medical Center from 1971 to 1981. The results were as follows: 1. The incidence of perforating eye injuries was 0.3% of 39,721 patients and 8.7% of the ocular trauma. 2. Of patients with perforating eye injuries, 76.7% were male and 23.3% female. Perforated injuries peaked in the age group 10-19 years, with about 50% of the perforations incurred by patients in the age group 10-29 years. 3. Of perforating eye injuries, 51.7% were found in the right eye, whereas 43.1% were in the left eye. 5.2% had injuries in both eyes. 4. The corneal perforations were 60.3% of the injuries, while the scleral were 25%, and the corneoscleral 14.7%. 5. Of perforating injuries, 16.4% were caused by intraocular foreign bodies, 78.9% of which were magnetic 89.5% of the patients were males. 6. Of perforating eye injuries, 32.8% occurred in the fall and 13.8% in September. 7. The most common material(23.3%) which caused perforating injuries was metal or iron particles. 15.5% of perforating injuries were caused by broken glass, 9.5% by explosives, and 7.8% by wood splinters. 8. Associated ocular manifestations were as follows: subconjunctival hemorrhage 42.2%, prolapse of uveal tissue 37.9%, conjunctival laceration 29.3%, traumatic hyphema 27.6%, tra umatic cataract 25.9% and traumatic uveitis 17.2%. 9. Of perforating eye injuries, 57.4% were treated by surgical procedure, such as primary closure, iridectomy, replacement of the prolapsed iris, lens extraction and removal of intraocular foreign bodies. In 13.9% of injured eyes removal of the eye-ball was performed. 10. Only 19.8% of the injuries were restored to 0.6 or better and 64.0% to 0.1 or less. 11. The location of the perforation was not correlated with visual prognosis. Relatively good vision was restored in scleral perforation cases, while corneal perforations resulted in the worst vision(statistically not significant). 12. The restored visual acuity was better in occupational injuries than in nonoccupational ones(statistically not significant). 13. Better results were obtained in the cases involving magnetic intraocular foreign bodies than in those with non-magnetic ones(statistically not significant). 14. The more complications occurred, the worse vision became. 15. The cases(38) of restoration of visual acuity considered to be poor(< or =0.1) breakdown as fo llows(by cause): phthisis bulbi(18.6%), traumatic cataract(10.5%), corneal opacity(81.0%), and vitreous opacity(3.5%).
Cataract ; Corneal Perforation ; Explosive Agents ; Eye Injuries* ; Female ; Foreign Bodies ; Glass ; Hemorrhage ; Humans ; Hyphema ; Incidence ; Iridectomy ; Iris ; Iron ; Lacerations ; Male ; Occupational Injuries ; Prognosis ; Prolapse ; Uveitis ; Visual Acuity ; Wood

We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS(R) solution at -70degrees C for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.
Aged, 80 and over ; Cornea/injuries/*surgery ; Corneal Perforation/pathology/physiopathology/*surgery ; Corneal Transplantation/*methods ; *Cryopreservation ; Eye Injuries, Penetrating/pathology/physiopathology/*surgery ; Female ; Follow-Up Studies ; Humans ; *Tissue Donors ; Visual Acuity

We describe herein a case of an impending corneal perforation with a large descemetocele in a patient with previous penetrating keratoplasty (PKP) that subsequently was treated with an emergent lamellar keratoplasty using frozen preserved cornea. A 76-year-old male patient, who had a PKP, presented with a completely whitish and edematous graft accompanied by large epithelial defects. Although antibiotics and antiviral agents were tried for three days, the corneal stroma abruptly melted, except for the Descemet's membrane and endothelium. Cryopreserved corneal tissue that was kept at -80degrees C was thawed and sutured on top of the remaining Descemet's membrane and endothelium. Pathological and microbiological tests were conducted using the remaining donor and recipient corneal tissues. After tectonic corneal transplantation on top of a large descemetocele, a healthy graft and relatively clear interfaces between graft-host junctions were maintained without serious adverse reactions throughout 6 month follow-up period. Microbiological evaluations of donor tissue at the time of thawing and tissue preparation were done, and the results were all negative. Tissue that was taken intraoperatively from the recipient cornea also showed negative microbiological results. In conclusion, tectonic lamellar keratoplasty, using cryopreserved corneal tissue, only onto the remaining Descemet's membrane and endothelium in an emergent condition, was a safe and effective treatment.
Cornea/*surgery ; Corneal Perforation/pathology/physiopathology/*surgery ; Corneal Transplantation/*methods ; *Cryopreservation ; Eye Injuries, Penetrating/pathology/physiopathology/*surgery ; Female ; Humans ; Keratoplasty, Penetrating ; Male ; Middle Aged ; *Tissue Donors ; Treatment Outcome ; Visual Acuity

1,072 cases of ocular injuries, including 271 cases of in-patients, who visited department of ophthalmology of Chungnam National University Hospital from January 1,1981 to December 31, 1985, were clinically analyzed. The results were as follows: 1. The incidence of ocular injuries was 8.1% of all eye patients and 16.0% of all patients admitted to this ophthalmologic department. 2. The incidence was more common in male(82.0%) and in the age of 3rd to 4th decades(53.7%). 3. Monocular injuries accounted for 90.4% of ocular injuries. There was no significant difference in the incidence between the right and left eye. 4. Tho ocular injuries were more common in the spring(27.4%), but in children the incidence was higher during the vacation. 5. The patients who visited this hospital within 24 hours after injury accounted for 89.8%. 6. The most common cause of ocular injuries was fist or finger(15.9%), followed by iron products(12.6%) and traffic accident(10.9%), but the injuries by iron products(32.1%) were most common in the admitted patients. 7. The most common ocular injury was eyelid laceration (15.3%), followed by subconjunctival hemorrhage(12.5%) and conjunctival foreign body(8.6%). In the cases of in-patients, corneal laceration(21.2%) was most common, followed by corneoscleral laceration(14.9%) and lens perforation(10.2%). The corneal perforation was 52.1% of all perforating eye injuries. 8. Surgical procedure included corneal suture(21.1%), lensectomy(12.5%), enucleation or evisceration(11.2%), and others. 9. Visual acuity was improved in most cases by treatment, but the corrected vision after treatment was less than 0.1 in 33.2%, which was mainly due to the perforating eye injuries. 10. The most common complication of ocular injuries after treatment was corneal opacity(36.3%), followed by secondary glaucoma(14.6%) and traumatic cataract(6.4%).
Child ; Chungcheongnam-do ; Corneal Perforation ; Eye Injuries ; Eyelids ; Humans ; Incidence ; Iron ; Lacerations ; Ophthalmology ; Visual Acuity

We report a case of a retained graphite anterior chamber foreign body that was masquerading as stromal keratitis. A 28-year-old male visited with complaints of visual disturbance and hyperemia in his right eye for four weeks. On initial examination, he presented with a stromal edema involving the inferior half of the cornea, epithelial microcysts, and moderate chamber inflammation. Suspecting herpetic stromal keratitis, he was treated with anti-viral and anti-inflammatory agents. One month after the initial visit, anterior chamber inflammation was improved and his visual acuity recovered to 20/20, but subtle corneal edema still remained. On tapering the medication, after three months, a foreign body was incidentally identified in the inferior chamber angle and was surgically removed resulting in complete resolution of corneal edema. The removed foreign body was a fragment of graphite and he subsequently disclosed a trauma with mechanical pencil 12 years earlier. This case showed that the presence of an anterior chamber foreign body should always be considered in the differential diagnosis of idiopathic localized corneal edema.
Adult ; Anterior Chamber/*injuries/pathology ; Corneal Stroma/*pathology ; Diagnosis, Differential ; Eye Foreign Bodies/*diagnosis/physiopathology/surgery ; Eye Injuries, Penetrating/*diagnosis/physiopathology/surgery ; *Graphite ; Humans ; Keratitis/*diagnosis ; Male ; Ophthalmologic Surgical Procedures ; Visual Acuity

No abstract available.
Eye Foreign Bodies/*etiology ; Eye Injuries, Penetrating/*etiology ; Humans ; Lens, Crystalline/*injuries ; Male ; *Metals

Cornea ; surgery ; Corneal Injuries ; Equipment Design ; Eye Foreign Bodies ; surgery ; Humans ; Surgical Instruments

OBJECTIVETo observe the expression of laminin and fibronectin in alkali-burned corneas in rats.

METHODSA total of 18 normal Wistar rats were randomly divided into 6 groups (n = 3 in each group). For each rat, one eye was injured by alkali burn, the other one was taken as the normal control. Then all the corneas were surgically removed and the expression of laminin and fibronectin was observed with immunohistochemistry respectively at 7 hours, 1 day, 3 days, 7 days, 14 days and 28 days after alkali burn.

RESULTSCompared with that of the normal controls, the expression of laminin and fibronectin of the burned eyes was dramatically higher at 7 hours, reached peak at 14 days and decreased to the normal level at 28 days after alkali burn.

CONCLUSIONSIn the process of wound healing after alkali burn, the expression of laminin and fibronectin increases dramatically, which suggests that laminin and fibronectin may participate in the process of corneal wound healing.

Animals ; Burns, Chemical ; metabolism ; Corneal Injuries ; Eye Burns ; metabolism ; Fibronectins ; metabolism ; Immunohistochemistry ; Laminin ; metabolism ; Rats ; Rats, Wistar ; Wound Healing ; physiology

Alkalies/therapeutic use* ; Burns, Chemical/drug therapy* ; Corneal Injuries/drug therapy* ; Eye Burns/drug therapy* ; Humans ; Taurine

Objective: To evaluate the accuracy of the Classification and Regression Tree (CART) model in prognosticating visual outcomes of patients with open-globe injuries Methods: This was a retrospective, single-center, cohort study of patients with open-globe injuries seen over a two-year period. Purposive sampling of hospital medical records was done to collect data from both in- and out-patient cases. The CART algorithm was utilized to determine the predicted visual outcome for each case, and the accuracy of prognostication was measured by computing for sensitivity, specificity, positive predictive value, and negative predictive value. The area under the receiver operating characteristic curve was used to check its discriminatory capability. Results: A total of 65 eyes (65 patients) with the following diagnoses based on the Birmingham Eye Trauma Terminology (BETT) classification were included: penetrating eye injury (n=58), globe rupture (n=2), and intraocular foreign body (n=5). Majority were male patients (81.5%) in the 17-39 year age group (40%). The sensitivity and specificity of CART were 100% (95% CI 93.6 to 100%) and 77.8% (95% CI 40 to 97.2%), respectively, with an overall accuracy of 96.9% (95% CI 89.3 to 99.6%). Area under the curve (AUC) was statistically significant at 0.89 (95% CI 0.79 to 0.95), indicating that the CART model can discriminate vision survival versus no vision. Conclusion The CART model demonstrated high accuracy in prognosticating visual outcomes after an openglobe injury in the local setting. It may be used as a helpful tool to guide treatment decisions in open-globe injuries.
Eye Injuries, Penetrating