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  • Title: [Penetrating intraocular injuries caused by foreign bodies of organic origin] ].
    Author: Dolezalová J, Rusnák S, Rícarová R.
    Journal: Cesk Slov Oftalmol; 2001 Nov; 57(6):381-6. PubMed ID: 11833270.
    Abstract:
    OBJECTIVE: To demonstrate two eyes of two patients with a penetrating injury by an organic intraocular foreign body (CNT), to outline the course of treatment and to evaluate anatomical and functional results. MATERIAL AND METHODS: During the period between May and July 1999 the authors treated at their department an 11-year-old girl and a 17-year old boy with a penetrating CNT injury of organic origin. In the girl they extracted a CNT which pierced the sclera and protruded into the vitreous body. The foreign body was extracted by means of a forceps, the site of perforation was treated by a cryosurgical procedure with a radial Silastic filling. The man was shot into the OL by a grain of pepper from an air-gun. The organic body in the vitreous body caused a violent inflammatory reaction in the vitreous body and retina. Early extraction of the CNT could not be made because of an adverse corneal finding which made surgery impossible. The progressing proliferative vitreoretinopathy (PVR) led to repeated formation of epiretinal, subretinal and cyclitic membranes which caused relapsing detachment of the retina (OS). The foreign body was extracted during pars plana vitrectomy (PPV) by the transvitreal route using a forceps. Definite adherence of the retina was achieved during the third PPV, membranectomy and implantation of silicone oil (SO). Final functional success was achieved by eliminating SO and by partial perforating keratoplasty. RESULTS: The CNT in the girl was histologically and parasitologically identified as a fibre of animal origin (animal hair or human eyelash). The follow up period is six months, VOP-5/5 nat., NOT 17 torr, bulbus undisturbed. In the second patient the cultivation finding from the vitreous body was negative. Extensive PVR developed as a result of breakdown products of the organic CNT and led to relapsing OS. Three months after the last operation the bulbus is at rest, the corneal disc clear, the retina attached, VOL-3/60 s + 8.0 D steop., NOT 12 torr. CONCLUSIONS: The final results of treatment of severe devastating penetrating injuries by a CNT is determined by the preoperative condition of the ocular tissues. CNT of organic origin damage intraocular tissues by their breakdown products as well as by more frequent contamination with pathological microorganisms. Our experience provided evidence that penetrating injuries by non-infected CNT of organic origin have a favourable prognosis. But even relapsing and prolonged OS after extraction of the CNT of organic origin and endophthalmitis need not lead to loss of the eye or its function.
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