Perfluorocarbon liquid-assisted intraocular foreign body removal

A Perfluorocarbon-Coated ZrP Cation Exchanger with Excellent Ammonium Selectivity and Chemical Stability: An Oral Sorbent for End-Stage Kidney Disease (ESKD)

An oral sorbent to remove NH₄⁺ within the small intestine of end-stage kidney disease (ESKD) patients could reduce blood urea levels and diminish their dialysis treatment burden. But current sorbent materials like amorphous zirconium phosphate particles Zr(HPO₄)₂·H₂O (ZrP) lack the selectivity to remove NH₄⁺ in water solution with other competing ions. Our previous work found that a gas-permeable, hydrophobic polydimethylsiloxane (PDMS) coating on ZrP improved the material's selectivity for NH₄⁺. However, a competing ion Ca²⁺ was still removed by PDMS-coated ZrP sorbent, and the permeability of the PDMS coating to Ca²⁺ was increased after low-pH stomach-like condition exposure. An alternative hydrophobic and gas permeable coating has been investigated─perfluorooctyltriethoxysilane (FOTS). The coating was attached in place of PDMS to a tetraethyl orthosilicate-coated ZrP surface. Surface atomic composition analysis and scanning electron microscopy observation verified the successful application of the FOTS coating. Water contact angle analysis validated the FOTS coating was hydrophobic (145.0 ± 3.2°). In vitro competing ion studies indicated the FOTS coating attached to ZrP increased NH₄⁺ removal by 53% versus uncoated ZrP. FOTS offers complete selectivity for NH₄⁺ over Ca²⁺ with similar NH₄⁺ capacity as the previous PDMS coating. Moreover, FOTS-coated ZrP maintained NH₄⁺ removal capacity and selectivity after the acid exposure study, indicating excellent acid resistance while NH₄⁺ selectivity of ZrP-PDMS decreased by 72%. The results suggested that FOTS-coated ZrP is promising as an oral sorbent for ESKD patients.

Total Filling of the Vitreous Cavity With a Cohesive Ophthalmic Viscosurgical Device to Support the Removal of the Intraocular Foreign Body

PURPOSE

To evaluate the effectiveness of loading the vitreous cavity with a cohesive ophthalmic viscosurgical device in aiding the removal of the posterior segment intraocular foreign body (IOFB).

METHODS

Seven consecutive patients underwent a small-gauge vitrectomy due to eye trauma with the IOFB between January 2019 and December 2019. The IOFB removal was initiated after total filling the vitreous cavity with the ophthalmic viscosurgical device (Eyefill C or Bio-Hyalur Plus) to facilitate maneuvering and slow the descent in cases of the unintendedly released IOFBs. The eye examination was performed at presentation and at 1 day, 7 days, 1 month, and 3 months after surgery. The best-corrected visual acuity and intraocular pressure were evaluated.

RESULTS

In all eyes, IOFBs were elevated into the center of the vitreous cavity and could be securely gripped while suspended in the ophthalmic viscosurgical device to allow the surgeon for successful and harmless removal. In the 3-month follow-up, the best-corrected visual acuity was 20/20 in 5 patients and 20/25 in 2 patients. In the early postoperative period, the elevation of intraocular pressure did not occur. No patient developed endophthalmitis.

CONCLUSION

The authors demonstrated that this uncomplicated technique is an effective surgical option for more reliable removal of posterior segment IOFBs.

INCIDENCE AND RISK FACTORS OF POSTOPERATIVE ENDOPHTHALMITIS AFTER PRIMARY SURGICAL REPAIR COMBINED WITH INTRAOCULAR FOREIGN BODY REMOVAL

PURPOSE

To analyze the incidence and risk factors of postoperative endophthalmitis after primary surgical repair and intraocular foreign body (IOFB) removal within 24 hours of injury.

METHODS

The records of all patients treated surgically for open globe injury and IOFB removal at the Eye Hospital of Shandong First Medical University between January 1, 2015, and June 30, 2020, were retrospectively reviewed. Variables included time from injury to operation, cause of injury, details of surgical repair, and follow-up. The incidence and risk factors of endophthalmitis after IOFB removal were studied.

RESULTS

During 5 years, 99 patients with IOFB were reviewed. Of these, 19 patients were diagnosed with endophthalmitis on admission, and 5 were suspected of having endophthalmitis during operation. Fifty-four cases had no clinical signs of endophthalmitis on admission and during operation and were treated with operation within 24 hours after the injury. Two patients (2 of 54; 3.70%) developed endophthalmitis after IOFB removal, and the causative agent in both cases was Bacillus cereus.

CONCLUSION

The incidence of infectious endophthalmitis after primary surgical repair combined with IOFB removal (≤24 hours) was 3.70% in patients who received a series of standard treatments, and B. cereus infection might be a risk factor.

A Cross-Knotted Suture Basket Technique for Large Nonmagnetic Intraocular Foreign Body Removal

Purpose

To report a novel technique of cross-knotted suture basket and to test its effectiveness in large nonmagnetic intraocular foreign body (IOFB) removal.

Methods

A 7/0 Vicryl suture was cut in half and cross-knotted, and four ends were introduced into a 23G needle to form a basket. Pig eyes were used to set up the IOFB model, and the effectiveness of the suture basket in the removal of large nonmagnetic intraocular foreign bodies was tested.

Results

Several modifications can be made to adapt to different situations. For the materials (stone, metal, glass, and wood) and shapes (irregular, spherical, and rectangle) of large IOFB tested, the cross-knotted suture basket successfully removed all kinds of IOFBs.

Conclusion

The suture basket technique provides an accessible, safe, and effective alternative in large nonmagnetic IOFB removal. It can be adapted and interchangedand also worth's further clinical investigations.