Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries
PurposeTo explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion.DesignProspective cohort, hospital-based study.MethodsA total of 24 patients who were diagnosed with chor...
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.801068/full |
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| author | Huijin Chen Huijin Chen Jiarui Yang Jiarui Yang Changguan Wang Changguan Wang Xuefeng Feng Xuefeng Feng Kang Feng Kang Feng Zhizhong Ma Zhizhong Ma |
| author_facet | Huijin Chen Huijin Chen Jiarui Yang Jiarui Yang Changguan Wang Changguan Wang Xuefeng Feng Xuefeng Feng Kang Feng Kang Feng Zhizhong Ma Zhizhong Ma |
| author_sort | Huijin Chen |
| collection | DOAJ |
| description | PurposeTo explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion.DesignProspective cohort, hospital-based study.MethodsA total of 24 patients who were diagnosed with choroidal avulsion were enrolled in this study. The demographic characteristics, baseline information of trauma, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected before surgery, and the anatomic abnormities of the globe were recorded before or during surgery. All patients were diagnosed with choroidal avulsion and underwent choroid suturing treatment during vitrectomy, postoperative functional variables including BCVA and IOP, anatomic variables including retinal and choroidal reattachment rate, and silicone oil migration rate, which were recorded at the regular follow-ups at least 1 year after surgery.ResultsAll patients with open globe injury involved zone III, 70.8% of the patients presented with two quadrants of the avulsed choroid, and 29.2% with one quadrant involved; moreover, all patients had complications with retinal detachment (RD), of which 58.3% of patients had closed funnel retinal detachment. TSS was applied in nineteen patients and IOS in five patients. Postoperatively, a significant improvement on LogMAR BCVA was observed at each follow-up from 3.57 ± 0.69 before surgery to 2.82 ± 0.98 at the last follow-up (p < 0.05), and the proportion of no light perception (NLP) was also reduced from 69.6 to 37.5%. IOP was markedly elevated from 6.4 ± 4.1 mmHg preoperatively to 11.3 ± 4.3 mmHg at the last follow-up (p < 0.05). Choroidal reattachment was achieved in 91.7% of patients; two patients were observed with silicone oil migration at 3 months after surgery and underwent drainage of suprachoroidal silicone oil and sclera buckling. Meanwhile, retinal attachment was observed in 95.8% of patients, only one patient developed partial RD due to postoperative proliferative vitreoretinopathy, and secondary vitrectomy was performed; all patients were observed with complete retinal and choroidal attachment at the last follow-up. Eventually, four patients were silicone oil-free, and 20 patients were silicone oil-dependent.ConclusionsChoroidal suturing proved to be an effective method to fix the avulsed choroid, which greatly improved the BCVA and maintained the IOP, and efficiently increased the choroidal and retinal reattachment rate and preservation of the eyeball. |
| first_indexed | 2024-04-11T18:21:37Z |
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| id | doaj.art-fa2b96073cbd4c358bf9e9e0094df77f |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-11T18:21:37Z |
| publishDate | 2022-01-01 |
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| spelling | doaj.art-fa2b96073cbd4c358bf9e9e0094df77f2022-12-22T04:09:45ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-01-01810.3389/fmed.2021.801068801068Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe InjuriesHuijin Chen0Huijin Chen1Jiarui Yang2Jiarui Yang3Changguan Wang4Changguan Wang5Xuefeng Feng6Xuefeng Feng7Kang Feng8Kang Feng9Zhizhong Ma10Zhizhong Ma11Department of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, ChinaDepartment of Ophthalmology, Peking University Third Hospital, Beijing, ChinaBeijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, ChinaPurposeTo explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion.DesignProspective cohort, hospital-based study.MethodsA total of 24 patients who were diagnosed with choroidal avulsion were enrolled in this study. The demographic characteristics, baseline information of trauma, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected before surgery, and the anatomic abnormities of the globe were recorded before or during surgery. All patients were diagnosed with choroidal avulsion and underwent choroid suturing treatment during vitrectomy, postoperative functional variables including BCVA and IOP, anatomic variables including retinal and choroidal reattachment rate, and silicone oil migration rate, which were recorded at the regular follow-ups at least 1 year after surgery.ResultsAll patients with open globe injury involved zone III, 70.8% of the patients presented with two quadrants of the avulsed choroid, and 29.2% with one quadrant involved; moreover, all patients had complications with retinal detachment (RD), of which 58.3% of patients had closed funnel retinal detachment. TSS was applied in nineteen patients and IOS in five patients. Postoperatively, a significant improvement on LogMAR BCVA was observed at each follow-up from 3.57 ± 0.69 before surgery to 2.82 ± 0.98 at the last follow-up (p < 0.05), and the proportion of no light perception (NLP) was also reduced from 69.6 to 37.5%. IOP was markedly elevated from 6.4 ± 4.1 mmHg preoperatively to 11.3 ± 4.3 mmHg at the last follow-up (p < 0.05). Choroidal reattachment was achieved in 91.7% of patients; two patients were observed with silicone oil migration at 3 months after surgery and underwent drainage of suprachoroidal silicone oil and sclera buckling. Meanwhile, retinal attachment was observed in 95.8% of patients, only one patient developed partial RD due to postoperative proliferative vitreoretinopathy, and secondary vitrectomy was performed; all patients were observed with complete retinal and choroidal attachment at the last follow-up. Eventually, four patients were silicone oil-free, and 20 patients were silicone oil-dependent.ConclusionsChoroidal suturing proved to be an effective method to fix the avulsed choroid, which greatly improved the BCVA and maintained the IOP, and efficiently increased the choroidal and retinal reattachment rate and preservation of the eyeball.https://www.frontiersin.org/articles/10.3389/fmed.2021.801068/fullchoroidal avulsionocular traumatrans-scleral mattress suturingintraocular suturingno light perception |
| spellingShingle | Huijin Chen Huijin Chen Jiarui Yang Jiarui Yang Changguan Wang Changguan Wang Xuefeng Feng Xuefeng Feng Kang Feng Kang Feng Zhizhong Ma Zhizhong Ma Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries Frontiers in Medicine choroidal avulsion ocular trauma trans-scleral mattress suturing intraocular suturing no light perception |
| title | Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries |
| title_full | Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries |
| title_fullStr | Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries |
| title_full_unstemmed | Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries |
| title_short | Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries |
| title_sort | novel suturing methods for the management of traumatic choroidal avulsion in globe injuries |
| topic | choroidal avulsion ocular trauma trans-scleral mattress suturing intraocular suturing no light perception |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.801068/full |
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