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Intraoperative B-scan ultrasonography and pars plana vitrectomy for severe open globe injury with hemorrhagic retinal and choroidal detachment

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Abstract

Purpose

Our purpose was to report the initial clinical experience of intraoperative B-scan ultrasonography in combination with 25-gauge pars plana vitrectomy for severe open globe injury with hemorrhagic retinal and choroidal detachment.

Methods

Six eyes of six consecutive patients with severe open globe injury underwent intraoperative B-scan ultrasonography and 25-gauge pars plana vitrectomy at Osaka University Hospital in Japan. The feasibility of intraoperative B-scan ultrasonography, best-corrected visual acuity (BCVA), retinal reattachment, and intraoperative and postoperative complications were evaluated.

Results

Five patients presented with a ruptured globe and one patient with double penetration. Preoperative best-corrected visual acuity was no light perception in four eyes and light perception in two eyes. All patients underwent intraoperative B-scan ultrasonography and 25-gauge pars plana vitrectomy within 12 h after open globe injury. Intraoperative B-scan ultrasonography was feasible in all cases and was useful for diagnosing choroidal hemorrhage (four eyes), massive subretinal hemorrhage (two eyes), and retinal detachment (five eyes). In addition, serial real-time B-scan imaging facilitated successful evacuation of the choroidal hemorrhage and massive subretinal hemorrhage by external drainage, resulting in opening of the vitreous space to allow subsequent pars plana vitrectomy without entry site-related complications. After surgery, all patients had successful retinal attachment, and there was no loss of light perception.

Conclusion

Intraoperative B-scan ultrasonography is technically feasible and may potentially improve the safety and efficacy of severe open globe injury repair.

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Authors and Affiliations

  1. Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, E-7 Suita, Osaka, 565-0871, Japan

    Nobuhiko Shiraki, Taku Wakabayashi, Tatsuhiko Sato, Hirokazu Sakaguchi & Kohji Nishida

Authors
  1. Nobuhiko Shiraki
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  2. Taku Wakabayashi
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  3. Tatsuhiko Sato
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  4. Hirokazu Sakaguchi
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  5. Kohji Nishida
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Corresponding author

Correspondence to Taku Wakabayashi.

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Funding

No funding was received for this research.

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Financial disclosures

No authors have a proprietary interest or conflict of interest in any products mentioned in this article.

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Shiraki, N., Wakabayashi, T., Sato, T. et al. Intraoperative B-scan ultrasonography and pars plana vitrectomy for severe open globe injury with hemorrhagic retinal and choroidal detachment. Graefes Arch Clin Exp Ophthalmol 255, 2287–2291 (2017). https://doi.org/10.1007/s00417-017-3771-1

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  • DOI: https://doi.org/10.1007/s00417-017-3771-1

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