Simultaneous penetrating injury in both eyes (a case report)

    Adstract

    Simultaneous penetrating injury in both eyes (a case report)

    N.P. Sobolev, D.S. Afanasyeva

    The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow

    

    This clinical report is aimed to present the tactics of complex treatment in case of the concomitant trauma of the anterior eye segment caused by penetrating injury of the eyeball. The patient applied to us with the simultaneous injury of both eyes with the beak of the bird. Four days later after the injuring we observed in the primary examination the following status of both eyes: penetrating corneal scar across the optical zone, corneal suture, exudate in the aqueous humor, hypopion in the right eye; traumatic cataract, in the right eye with lens subluxation, rupture of lens capsule and efflux of the lens material into the anterior chamber; partial aniridia and iridodilysis, on the left eye – swelling cataract. Due to the inflammation, in order to prepare for the surgical intervention the patient was treated with antiinflammatory, antibacterial, antifungal and fibrinolytic agents.

    The surgeon had to reverse inflammatory reaction, to choose the most appropriate tactic considering the corneal edema, a low visualization, concomitant injury of structures of the anterior eye segment, failure by the accurate IOL calculation. Seven days after the beginning of the treatment the positive dynamics was observed and we performed phacoemulsification of the cataract in the left eye with IOL implantation as well as repair of iridodialysis.

    Then, in the absence of inflammatory reaction five days later the similar surgical treatment was performed in the right eye.

    Results of the control examination in the early postoperative period were following: uncorrected visual acuity (UCVA) of the right eye was 0.002, of the left one – 0.3, intraocular pressure of both eyes was normal.

    We assume that the presented surgical tactics in case of the simultaneous penetrating injury of both eyes is like the delayed primary surgical debridement. Taking into consideration the application of less-invasive techniques, a wide availability of phacoemulsification, in the presence of technical possibilities and competent ophthalmic surgeons the similar combined surgical treatment should be recommended as soon as possible after the injuring for these patients.

    Key words: eye injury, phacoemulsification, iridodialysis repair, traumatic cataract.

    

    No author has a financial or proprietary interest in any material or method mentioned.