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

Bulbar rupture: “Close-as-you-go” technique … but when, where and why to stop?

Meeting Abstract

  • Matteo Forlini - Modena/Italy
  • P. Rossini - Ravenna/Italy
  • A. Aversano - Ravenna/Italy
  • C. Forlini - Ravenna/Italy

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. DocISOTRG2008P04

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/rg2008/08rg146.shtml

Veröffentlicht: 18. Juni 2008

© 2008 Forlini et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Purpose: The management of severe globe injuries depends on several factors that do not tolerate prefixed schemes or dogmas. The “close-as-you-go” technique consists in the restoration of the globe integrity suturing both cornea and sclera surfaces step by step as the wound opens. This in order to preserve the structure and avoid the globe collapse. When, where and why to stop? There are no precise limits.

Methods: We present a bulbar rupture with large and irregular scleral tear and collapsed globe. After reconstructing the sclera with “close-as-you-go” technique we started via pars plana infusion and removed the haemorrhage in the anterior chamber. The reconstruction went on with retinotomy and removal of vitreous and subretinal haematoma. F6H8/silicone oil tamponade was injected.

Results: After 40 days the removal of the double tamponade: central retina was preserved, but peripheral PVR required the surgeon to perform limited retinotomies and retinectomies with new silicone oil tamponade. After six month the retina is flat.

Conclusion: The surgeon's experience and capabilities play a decisive role in this kind of surgery. However, designing a strategy that may the allow the surgeon to proceed in the different surgical steps improve the prognosis in complex cases, avoiding the patient to undergo different surgeries.

Take Home Message: The equipment available together with the surgeon's experience played a major role in this reconstruction to achieve the final result in a single step.