Advertisement

Case 5: Limbus to Limbus Corneal Laceration from Nail Gun Injury

  • Rohini Rao
  • John B. Miller
  • Seanna Grob
Chapter

Abstract

A 23-year-old-man presented with a large Zone I-II open globe injury of the left eye after a nail gun injury. The patient underwent repair of his corneal limbus to limbus laceration. During this time, the posterior lens capsule was noted to be violated with lens material and vitreous in the anterior chamber. Given the known posterior lens capsule violation, the lens was not taken primarily. The patient was then referred to retina and underwent a pars plana vitrectomy and lensectomy and was left aphakic. After three months of post-operative follow up, corneal suture removal was initiated. Suture removal was approached in a staged fashion over three visits spanning a month’s time. The patient was then referred to the contact lens service for evaluation six weeks after final suture removal and was fitted with a contact lens, resulting in best corrected vision of 20/25. Limbus to limbus lacerations require slow and staged suture removal to prevent wound leaks or complete dehiscence.

Keywords

Corneal laceration Limbus-limbus laceration Corneal sutures 

References

  1. 1.
    Hamill MB. Corneal and scleral trauma. Ophthalmol Clin N Am. 2002;15:185–94.CrossRefGoogle Scholar
  2. 2.
    John B, Raghavan C. Open globe injuries-primary repair of corneoscleral injuries. Kerala J Ophthalmol. 2010;22:225–34.Google Scholar
  3. 3.
    Lee BL, Sternberg PJ. Ocular nail gun injuries. Ophthalmology. 1996;103:1453–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Burger BM, Kelty PJ, Bowie EM. Ocular nail gun injuries: epidemiology and visual outcomes. J Trauma. 2009;67:1320–2.CrossRefPubMedGoogle Scholar
  5. 5.
    Kolomeyer AM, et al. Nail gun-induced open-globe injuries: a 10-year retrospective review. Retina. 2014;34:254–61.CrossRefPubMedGoogle Scholar
  6. 6.
    Bauza AM, et al. Work-related open-globe injuries: demographics and clinical characteristics. Eur J Ophthalmol. 2013;23:242–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Mannan R, Jhanji V, Sharma N, Pruthi A, Vajpayee RB. Spontaneous wound dehiscence after early suture removal after deep anterior lamellar keratoplasty. Eye Contact Lens. 2011;37:109–11.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OphthalmologyHarvard Medical School, Massachusetts Eye and EarBostonUSA
  2. 2.Vitreoretinal Surgery, Department of OphthalmologyHarvard Medical School, Massachusetts Eye and EarBostonUSA

Personalised recommendations