Artikel
Management of severe ocular rupture with endophthalmitis with a modified vitrectomy technique using a standard phacoemulsification machine and an external light source
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Veröffentlicht: | 18. Juni 2008 |
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Background: To report the short-term follow-up results of a severe ocular rupture with endopththalmitis which was managed with a modified vitrectomy technique.
Methods: A 41 year old, male Ghanaian sustained blunt ocular rupture on his left eye, from an exploded carbonated drink bottle. The left eye presented a 4mm scleral tear inferiorly. Further findings were a hypopyon, traumatic cataract, and total choroidal detachment. Visual acuity at presentation was counting fingers. The scleral laceration was repaired using 7-0- vicryl suture under an operating microscope. A posterior chamber maintainer was inserted through a slit scleral incision at the one’oclock position and connected to a 500 ml infusion bottle. The anterior vitrectomy probe of a Phacoemulsification machine was inserted through a slit incision at the 10 o’clock position. Using a head-mounted opthalmoscope and a sterlie 20 D condensor lens, vitrectomy was performed. Postoperative Follow up time is 3 months.
Results: One week post -operatively, best corrected visual acuity was 2/6. The anterior segment was quiet with traumatic cataract, the retina completely attached with bright red reflexes and without choroidal detachment. The vitreous was clear. Intra ocular pressure (IOP) was 12 mmHg. Visual acuity and the lens opacity remained stable after 3 months.
Conclusion: Vitrectomy machines are not yet available in many developing countries like Ghana. Some eye centres have quit good phaco machines with standard anterior vitrectomy ports and assessories. The authors describe a simple, yet very effective method to apply the phaco machine to selected cases requiring basic vitrectomy.