gms | German Medical Science

21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem
8. Symposium der International Society of Ocular Trauma

Deutsche Gesellschaft für Retinologie
International Society of Ocular Trauma

19.06. - 22.06.2008, Würzburg

Primary globe repair

Meeting Abstract

Suche in Medline nach

  • Rupesh V. Agrawal - Hyderabad/India

Retinologische Gesellschaft. International Society of Ocular Trauma. 21. Jahrestagung der Retinologischen Gesellschaft gemeinsam mit dem 8. Symposium der International Society of Ocular Trauma. Würzburg, 19.-22.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocISOTRG2008V069

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Veröffentlicht: 18. Juni 2008

© 2008 Agrawal.
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Concepts in management of corneo scleral lacerations:

Approach to a patient with Ocular Trauma:

Whenever confronted with a patient of ocular trauma, as an ophthalmologist one must 'take a step back' and try and rule out life threatening injuries. All the patients with open globe injuries should be evaluated on a emergency basis, evaluation should include brief history mainly highlighting about the details of incidence and object which lead to ocular trauma. Quick comprehensive clinical examination, making sure that no more trauma is caused to the traumatized eyes. The initial four prong management is carried out in patients with ocular trauma.

Four Pronged Initial Management
  • To minimize possibility of further trauma.
  • Minimize risk of infection.
  • Minimize psychological trauma to the patient and his family
  • Minimize legal problems to yourself and to your institute
Goals of primary globe repair:
  • Restoration of structural integrity
  • Achieve watertight closure
  • Prevent infection
  • Smooth and optically effective refractive surface
  • Refractive closure: Spherical cornea
    - minimize astigmatism
    - better contact lens fitting
  • Reduce scarring
  • Removal of disrupted lens and vitreous
  • Avoid uveal and vitreous incarceration
  • Removal of intraocular foreign bodies
  • Do no harm !
Surgical Principles:
  • 10-0 Nylon or 11-0 Nylon for cornea, 7-0 vicryl or 8-0 vicryl for sclera
  • Perpendicular to laceration
  • 90 % Depth
  • Equal depth
  • Length 1.5 - 2 mm
  • Knot : 2 - 1 - 1 or 3 - 1 - 1
  • Burying the knot
  • Vertical & Shelved Linear lacerations - Vertical incisions closed first
Get your concepts right:

Corneal wound repair being done by novice surgeon and the principles of primary globe repair are not adhered to (Figure 1 [Fig. 1]).

Wound revision being done for same eye by following up standard principles of corneal wound repair (Figure 2 [Fig. 2]).