fibrin and Eye-Foreign-Bodies

The study reported here was performed to investigate morphologic intraocular reactions on the surface of metallic intraocular foreign bodies (IOFB) with scanning electron microscopy.. Twenty-seven extracted IOFB were investigated. Of these, 22 were situated in the vitreous body; 19 had contact with the retina. Five IOFB had been removed from the anterior segment (control group). The duration of intraocular retention was 6 h to 24 days. Immediately after microsurgical removal the IOFB were fixed, dehydrated, dried, sputter-coated and investigated with a scanning electron microscope. Two IOFB from the vitreous were treated for collagen preservation.. Eighteen of 20 intravitreal IOFB showed fibers of fibrin on its surface; 11 of 20 were covered with a homogeneous layer. Within this layer a net of collagen fibers was detectable. A major cellular reaction was observed only on IOFB that injured the retina, pigment epithelium and choroid.. This morphologic study shows that: (1) a fibrin net develops in the vitreous around intravitreal IOFB; (2) depositions of amorphous material into the spaces of this net lead to dense coverage of the IOFB; (3) cellular reactions are not condition for the development of this coverage; (4) laceration of the retina induces a fibrocellular response.

Topics: Adolescent; Adult; Anterior Eye Segment; Collagen; Eye Foreign Bodies; Eye Injuries, Penetrating; Fibrin; Humans; Metals; Microscopy, Electron, Scanning; Middle Aged; Retina; Vitreous Body

Subtotal open-sky vitrectomy can be used to improve visual function in some eyes for which closed vitrectomy is useless. Open-sky vitrectomy allows easier access for surgical instruments, especially to anterior fundus structures. The technique also improves the visibility of intraocular structures. The surgical procedure, which uses special instruments and high-molecular-weight hyaluronic acid, is divided into four stages: preparation, operating inside the vitreous cavity, wound closure, and retinal reattachment. In 290 consecutive operations for which complete follow-up data are available, retinal reattachment was achieved in 61 eyes (21%). The greatest number of successes (16 of 30 cases [53%]) was achieved in severe tractional retinal detachments. Such results are encouraging because these eyes were considered inoperable by other techniques. Open-sky vitreous surgery is performed through a corneal incision, but a scleral incision over the pars plana may become the method of choice in selected cases. The development of a preretinal fibrin membrane, as a result of either a closed vitrectomy or an open-sky procedure, may be a major cause of postoperative failure. Hypotony during surgery is probably the main precipitating factor of intraocular fibrin membrane formation.

Topics: Adolescent; Adult; Cataract; Child; Child, Preschool; Eye Diseases; Eye Foreign Bodies; Eye Injuries; Female; Fibrin; Humans; Lens Subluxation; Male; Middle Aged; Retinal Detachment; Scleral Buckling; Vitreous Body

Topics: Aged; Anti-Bacterial Agents; Conjunctiva; Eosinophils; Eye Diseases; Eye Foreign Bodies; Eyelids; Female; Fibrin; Humans; Leukocytes; Male; Membranes; Middle Aged; Staining and Labeling