Mathan Jeremy John, Chandra Varun
General Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Case Rep Ophthalmol. 2022 Aug 16;13(2):626-629. doi: 10.1159/000525986. eCollection 2022 May-Aug.
The objective of this report was to describe a case of total traumatic iridodialysis in the context of blunt trauma with an orbital-floor fracture. A 76-year-old female presented post-fall with right-eye blunt trauma. She underwent canthotomy and cantholysis due to concern of orbital compartment syndrome in a regional hospital with emergency physicians clearing dark tissue near the lateral canthus at the time of canthotomy cantholysis. She had a traumatic expulsive iridodialysis with 360° loss of iris through the previous phacoemulsification wound in the clear cornea. The patient also had an orbital-floor fracture, which together with internal decompression through the previous phacoemulsification wound possibly prevented further damage to intraocular structures. There was good visual recovery. Herein, we propose that the combination of the orbital-floor fracture in tandem with the reopening of the previous phaco wound served as a decompressing mechanism to prevent further intraocular injury above that of total iridodialysis.
本报告的目的是描述一例在伴有眶底骨折的钝性创伤情况下发生的完全性外伤性虹膜根部离断病例。一名76岁女性跌倒后出现右眼钝性创伤。由于担心发生眶间隔综合征，她在一家地区医院接受了眦切开术和眦松解术，急诊医生在进行眦切开术和眦松解术时清理了外眦附近的深色组织。她发生了外伤性驱逐性虹膜根部离断，通过透明角膜上先前的白内障超声乳化伤口导致虹膜360°缺失。该患者还伴有眶底骨折，其与通过先前白内障超声乳化伤口进行的内减压一起，可能防止了眼内结构受到进一步损伤。患者视力恢复良好。在此，我们提出眶底骨折与先前白内障伤口重新开放相结合，作为一种减压机制，可防止除完全性虹膜根部离断之外的进一步眼内损伤。
