Quality of life after open-globe injury.
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Eye Enucleation↗
Biomedical subjects
Marc Rofail
Publications and source records attributed to Marc Rofail.
Prognostic indicators for open globe injury.
BACKGROUND: The purpose of the study is to identify factors predictive of outcome after open globe injury in 273 patients admitted to the Royal Brisbane Hospital, Queensland, Australia between 1992 and 2003. METHODS: Data were collected retrospectively regarding demographic and geographical factors, injury circumstances, initial visual acuity (VA), injury parameters, details of initial and subsequent surgery, final best corrected VA and complications. Multivariate analysis using binary logistic regression was utilized to identify which factors were related to outcome. RESULTS: 83% of patients were male, with a mean age of 38.3 years. The mean duration of follow up was 16.6 months and 58% of patients (135 of 231) achieved an overall improvement in their vision. Forty-one cases (15%) were enucleated, with half of these cases performed primarily. The prognostic factors indicating the likelihood of a VA of counting fingers or worse were poor initial VA, a large laceration >10 mm and the presence of a relative afferent pupil defect. Rural patients had a significantly worse final VA than city dwellers and had higher rates of endophthalmitis and enucleation. CONCLUSIONS: Assessment of prognostic factors at the time of presentation of an open globe injury enables realistic expectations of final visual outcome by the doctor and the patient. In order to improve outcomes in patients from rural areas, access to specialized eye services need to be upgraded.
Adolescent↗
Conjunctival benign reactive lymphoid hyperplasia associated with myopic scleral thinning.
Known causes of conjunctival salmon patches include lymphoma, amyloidosis, sarcoidosis, leukaemia and benign reactive lymphoid hyperplasia. The aetiology of benign reactive lymphoid hyperplasia is thought to be a localized reactive change induced by an irritative or antigenic stimulus. The case of benign reactive lymphoid hyperplasia reported herein occurred in a myopic patient with extremely thin sclera. The authors' hypothesis is that choroidal antigens are able to perfuse through thin sclera and act as chronic irritants to the overlying conjunctiva resulting in a lymphoid response and subsequent salmon patch formation.
Aged↗
Suicide-related perforating injury of globe with nail gun.
A case is reported of nail gun injury due to suicide attempt involving both orbits, frontal lobe and abdomen, which resulted in an unusual posterior perforation of the left globe. Injury was inflicted with a total of eight nails. Three nails entered the left orbit, one of which perforated the posterior aspect of the left globe. One nail entered the right orbit involving the optic nerve and crossed the midline to finish in the left sphenoid sinus. Three nails entered the frontal lobe near the midline and the final nail pierced the left lobe of the liver. The left eye underwent primary repair, lensectomy and vitrectomy with silicone oil and achieved a visual acuity of 6/60, 3 months post removal of oil with sutured posterior chamber intraocular lens. The right eye suffered traumatic optic neuropathy and currently has a visual acuity of 6/36 due to senile cataract formation. No other serious sequelae resulted from the other injuries and the patient has recovered from his episode of depression.
Brain Injuries↗
An improved holder for the wide-angle vitrectomy lens.
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Humans↗
Perfluoro-n-octane as a postoperative vitreoretinal tamponade in the management of giant retinal tears.
BACKGROUND: Despite recent advances in giant retinal tear repair, retinal redetachment remains an issue. This may be due to inadequate retinal tamponade with silicone oil or perfluorocarbon gas that allows fluid to seep back under the edge of the tear. We propose short-term postoperative retinal tamponade with perfluoro-n-octane liquid to overcome this problem. Theoretical advantages include the reduced likelihood of proliferative vitreoretinopathy. It is easier to remove than silicone oil due to its lower viscosity, and supine posturing is more manageable from a patient perspective. METHODS: A retrospective case series of 16 giant retinal tear repairs without significant proliferative vitreoretinopathy is presented. Lens-sparing vitrectomy was performed with endolaser to the edge of the tear and the entire retinal periphery. Scleral buckling was not utilized. Perfluoro-n-octane was used as a postoperative tamponade for a mean of 16.4 days (range, 6-50 days). RESULTS: The retina was reattached at the end of the procedure in all 16 cases. Redetachment occurred in only 1 (6.3%) of 16 cases. CONCLUSION: Postoperative tamponade with perfluoro-n-octane may decrease the rate of redetachment in giant retinal tear repair compared with silicone oil or perfluorocarbon gas alone. We found no adverse effects directly attributable to perfluoro-n-octane.
Adult↗
Migratory intraocular cilium following phacoemulsification.
A case of an intraocular cilium noted in the anterior chamber after routine small incision phacoemulsification is described. The cilium was noted on the third postoperative day. It initially protruded internally from the paracentesis site and subsequently pierced the peripheral iris to migrate through to the posterior chamber to finally re-emerge through the pupil and come to rest in the inferior angle. No adverse effects have been noted and the patient's visual acuity was stable at 6/5 after 6 months of follow up.
Anterior Chamber↗