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Anterior Segment Organ Culture Platform for Tracking Open Globe Injuries and Therapeutic Performance
Published on: August 25, 2021
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Epithelial invasion after open globe injury.
Arne Viestenz1, Berthold Seitz2, Anja Viestenz1
1Department of Ophthalmology, Martin-Luther-University Halle-Wittenberg, University Center Halle, Ernst-Grube Str. 40, Halle (Saale), 06120, Germany.
Clinical Anatomy (New York, N.Y.)
|June 15, 2017
Summary
Epithelial downgrowth following open globe injury can cause blindness. En bloc excision is the preferred treatment for cystic epithelial downgrowth, avoiding laser procedures that worsen outcomes.
Area of Science:
- Ophthalmology
- Surgical Pathology
Background:
- Epithelial invasion is a rare but serious complication following open globe injury.
- Improper treatment, such as laser opening of epithelial cysts, can lead to painful blindness.
Purpose of the Study:
- To evaluate the efficacy of en bloc excision for epithelial downgrowth after open globe injury.
- To determine the optimal surgical approach and contraindications for managing epithelial invasion.
Main Methods:
- Retrospective analysis of 25 patients who underwent tectonic keratoplasty with en bloc excision for epithelial downgrowth.
- Histological examination to differentiate between diffuse and cystic epithelial invasion.
- Assessment of pre- and post-operative visual acuity and intraocular pressure.
Main Results:
- Forty percent of patients with epithelial downgrowth had a history of open globe injury.
- En bloc excision was performed with a mean excision diameter of 8.2 mm.
- Mean visual acuity and intraocular pressure remained stable post-surgery, with a low incidence of ocular hypotony (4%).
Conclusions:
- En bloc excision is the therapy of choice for cystic epithelial downgrowth with an extension less than 150 degrees.
- Laser cystotomy or surgical opening of the cyst is contraindicated due to the risk of transforming cystic into diffuse invasion and secondary glaucoma.
- Epithelial invasion can manifest years after the initial open globe injury, emphasizing the need for appropriate long-term management.
