Author/Editor		Mertz, Manfred
Title		Management of severe corneoscleral lacerations
Translated title		Oskrba hudih korneo-skleralnih poškodb
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 71, št. Suppl 2
Publication year		2002
Volume		str. II-21-4
Language		eng
Abstract		Background. Ocular injuries, such as caused by windscreen glass particles or metallic foreign bodies, are very common. in most cases, the corneal laceration is found to be horizontal, and very often it crosses the limbus. Thereby, different tissues of the eyeball are involved simultaneously, e.g. iris root, sclera, outer muscles, trabecular meshwork, ciliary body, pars plana, lens, vitreous etc. For reconstruction and repair, a strong order of procedures is important. After exclusion or location of intraocular foreign bodies by x-ray or ultrasonic methods, the first aim has to be the stabilisation of the globe. First step should be a limbus reconstructing suture, to be followed by Tenon tent, Flieringa ring, scleral exploration (until the very end of the laceration is found, even by muscle surgery), and prefixing of a scleral buckle and/or cerclage if necessary. Not before all these tasks have been fulfilled, the anterior chamber should be entered, and repair of the lens, iris and cornea can be started. The globe being now stabilised in his whole entity, sometimes a primary vitrectomy can be necessary, and also this is the best point of time for the removal of an intraocular foreign body. Post-op treatment should be on in-patient base.
Summary		Izhodišča. Očesne poškodbe, kot npr. povzročene z drobci vetrobranskega stekla ali s kovinskimi tujki, so zelo pogoste. V večini primerov so poškodbe horizontalne in zelo pogosto prečkajo limbus. Pri tem je lahko naenkrat poškodovanih več očesnih tkiv, npr. baza šarenice, beločnica, zunanje očesne mišice, trabekulum, caliarnik, pars plana, leča, steklovina ipd. Pri rekonstrukciji je potreben natančen vrstni red. Po potrditvi in lokalizaciji tujka v očesu z radiološkimi ali ultrazvočnimi metodami je prvi cilj rekonstrukcije stabilizacija očesa. Prvi korak pri tem je šiv, ki rekonstruira limbus, nato pa sledi "šotor" Tenonove ovojnice, Flieringa obroč, eksploracija in pregled tesnosti beločnice in prednastavitev skleralne plombe in /ali serklaže, če je le-ta potrebna. V sprednji prekat naj ne bi vstopili, dokler ne izpolnimo teh pogojev, ki omogočajo začetek rekonstrukcije drugih delov očesa, kot so leča, šarenica in roženica. V očesu, ki je tako stabilizirano, je včasih potrebna tudi primarna vitrektomija, ob kateri je možno na najboljši način odstraniti intraokularni tujek. Pooperativno zdravljenje je potrebno izvajati v bolnišnici.
Descriptors		CORNEA SCLERA LIMBUS CORNEAE EYE INJURIES, PENETRATING