Dt. Sprunger et al., MANAGEMENT OF EXPERIMENTAL GLOBE PERFORATION DURING STRABISMUS SURGERY, Journal of pediatric ophthalmology and strabismus, 33(3), 1996, pp. 140-143
Background: The incidence of potentially vision-threatening globe perf
oration during strabismus surgery is reportedly between less than 1% a
nd 12% of cases. Optimal treatment of globe perforation is not known;
however, traditionally it has been treated with cryotherapy at the tim
e of surgery or observation without treatment. The indirect-ophthalmos
cope-directed diode laser may provide a safe and effective alternative
treatment. Methods: We perforated the globes of six adult Dutch rabbi
ts (12 eyes) and treated four eyes with cryotherapy and four with diod
e laser; the remaining four were not treated. Results: Histologic exam
ination of the untreated eyes revealed a cellular reaction around the
polyglactin suture that formed a non-uniform chorioretinal adhesion. T
he cryotherapy eyes had a tenuous chorioretinal adhesion and retinal p
igment epithelium (RPE) cells in the vitreous on several sections. The
laser-treated eyes had a firm, wide chorioretinal adhesion, with mini
mal tissue disruption and no release of RPE cells. No complications oc
curred. Conclusion: 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 usefu
l in humans.