Management of experimental globe perforation during strabismus surgery.
BACKGROUND
The incidence of potentially vision-threatening globe perforation during strabismus surgery is reportedly between less than 1% and 12% of cases. Optimal treatment of globe perforation is not known; however, traditionally it has been treated with cryotherapy at the time of surgery or observation without treatment. The indirect-ophthalmoscope-directed diode laser may provide a safe and effective alternative treatment.


METHODS
We perforated the globes of six adult Dutch rabbits (12 eyes) and treated four eyes with cryotherapy and four with diode laser; the remaining four were not treated.


RESULTS
Histologic examination of the untreated eyes revealed a cellular reaction around the polyglactin suture that formed a non-uniform chorioretinal adhesion. The cryotherapy eyes had a tenuous chorioretinal adhesion and retinal pigment epithelium (RPE) cells in the vitreous on several sections. The laser-treated eyes had a firm, wide chorioretinal adhesion, with minimal tissue disruption and no release of RPE cells. No complications occurred.


CONCLUSIONS
We conclude that indirect-ophthalmoscope-directed diode laser retinopexy was safe and efficacious for globe perforation during strabismus surgery on rabbits and could be expected to be useful in humans.
Sprunger
D T
DT
Midwest Eye Institute, Indianapolis, IN 46280-1381, USA.
Klapper
S R
SR
Bonnin
J M
JM
Minturn
J T
JT
D000818:Animals; D017679:Cryotherapy; D004195:Disease Models, Animal; D015807:Eye Injuries, Penetrating / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D007431:Intraoperative Complications / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D053685:Laser Therapy; D009887:Ophthalmoscopy; D010857:Pigment Epithelium of Eye / Q000473:pathology; D011817:Rabbits; D012166:Retinal Hemorrhage / Q000209:etiology / Q000473:pathology / Q000601:surgery; D012590:Sclera / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D013285:Strabismus / Q000601:surgery*