Ocular injuries from paintball pellets

OBJECTIVE

To evaluate the ocular effects of blunt trauma due to injury from a paintball pellet.

DESIGN

Noncomparative case series.

PARTICIPANTS

Thirteen patients who suffered ocular injury from paintballs are described. The patients presented to six different civilian and military emergency departments in tertiary care medical centers.

INTERVENTION

Patients were treated for the ocular injury.

MAIN OUTCOME MEASURES

Patients were evaluated for initial and final visual acuity. The reason for persistent loss of vision was delineated.

RESULTS

There were 12 males and 1 female with an average age of 21 years (range, 12-33 years). Eleven of the 13 had no ocular protection at the time of the ocular injury. On initial examination, nine patients had a hyphema, nine had a vitreous hemorrhage, six had a retinal tear or detachment, three had corneal or corneal-scleral ruptures, and one had traumatic optic neuropathy. The final visual acuity was 20/40 or better in two patients, 20/50 to 20/150 in three patients, and 20/200 or worse in eight patients.

CONCLUSION

Injuries due to paintball pellets can result in severe ocular damage and significant loss of vision. Eyecare professionals should be aware of the risks of this sport and must strongly advise participants to wear adequate protection when involved in this activity.

Retinal toxicity of intravitreally injected faeriefungin

Faeriefungin is a new antibacterial and antifungal agent derived from a strain of Streptomyces griseus var. autotrophicus. Under anesthesia, 12 albino rabbits underwent injection in their right eyes with 400, 200, 100, 40, 20, and 10 micrograms of faeriefungin. Retinal toxicity was assessed by electroretinography and light and transmission electron microscopy. Injection of 400 micrograms resulted in severe retinal toxicity, although indirect ophthalmoscopy was unremarkable. At 200 micrograms, there was moderate toxicity. Intravitreal injection of concentrations of 100 micrograms or less produced no neuroretinal toxicity. These data suggest that faeriefungin is a potentially useful drug in the treatment of fungal or bacterial endophthalmitis.

Repair of retinal detachment associated with proliferative vitreoretinopathy using perfluoroperhydrophenanthrene (Vitreon). Vitreon Study Group

A total of 140 consecutive patients underwent repair of retinal detachment associated with grade C2 to D3 proliferative vitreoretinopathy with perfluoroperhydrophenanthrene (Vitreon) as an intraoperative hydrokinetic tool. In seven patients the Vitreon was left in the eye for extended tamponade. Intraoperative reattachment was obtained in 98% of patients. At the final follow-up examination (mean 7 months) 84% of retinas remained attached, and 92% of patients had stable or improved visual acuity. Vitreon was found to be safe and effective in the repair of complicated retinal detachments. No complications were directly related to Vitreon when used intraoperatively or when left in the eye for extended tamponade.

Bioavailability of microsphere-entrapped cyclosporine A in the cornea and aqueous of rabbits

Extended release of immunosuppressive drugs and sustained drug levels are desirable for the treatment of corneal graft rejection and other ocular immune disorders. This experiment was conducted with biodegradable microspheres containing cyclosporine A to assess their suitability for achieving this goal. Microspheres containing cyclosporine A were prepared using a solvent evaporation process. A mixture of poly(lactic) and poly(glycolic) acid polymers (50:50) and cyclosporine A was dissolved in a mixture of chloroform and acetone. The solution was then emulsified in an aqueous solution of polyvinyl alcohol and stirred for 24 hours to evaporate the organic solvent. The final assayed concentration of cyclosporine A was 15.38 mg/mL. A 0.13 mL aliquot (2.0 mg) of the suspension of the microspheres was injected subconjunctivally in 24 eyes of white New Zealand rabbits. The concentration of cyclosporine A in the aqueous and cornea was measured at 6, 12, 24, 48, 72, and 144 hours after injection (n = 4 for each group). Corneal levels of cyclosporine A ranged from 2392 +/- 70 ng/mL at 6 hours to 1297 +/- 459 ng/mL at 144 hours. The aqueous levels ranged from 110 +/- 0 ng/mL at 6 hours to 62 +/- 11 ng/mL at 144 hours. These data indicate that a microsphere drug delivery system is an effective means of delivering cyclosporine A to the cornea and anterior chamber, and may provide an alternative for the treatment of ocular immune disorders.

Perfluoroperhydrophenanthrene (Vitreon) in the management of giant retinal tears: results of a collaborative study

Fifty cases of retinal detachment with a giant retinal tear were managed using perfluoroperhydrophenanthrene (Vitreon) as an intraoperative and postoperative tool. The giant tear was less than 180 degrees in 76% of the eyes, greater than 180 degrees in 22%, and greater than 270 degrees in 2%. Proliferative vitreoretinopathy was present in 40%. Vitreon was used only intraoperatively in 84% of the eyes, and was left in 16% for up to 4 weeks. Intraoperative retinal reattachment was achieved in 98%. Retinal attachment was maintained in 88%, with a mean follow up of 8.6 months. Postoperative visual acuity was better than 20/400 in 52%. Postoperative complications included cataract in 23%, choroidal effusion in 2%, hypotony in 4%, and recurrent retinal detachment with proliferative vitreoretinopathy in 26%.

A new synthetic absorbable suture for ophthalmic surgery: laboratory and clinical evaluation

A new synthetic absorbable suture for ophthalmic surgery--glycolactide--was proved superior to chromic collagen in rupture strength and more predictable absorption time in laboratory and clinical studies. The 8-0 glycolactide showed 30% greater initial strength than 8-0 chromic collagen. One week after implantation in rabbit corneas, the glycolactide retained over 90% of its initial rupture strength, while chromic collagen had lost nearly 50% of its strength. After ten days the strength of the glycolactide fell rapidly. By day 21 it began to be absorbed, completely disappearing by seven weeks. Chromic collagen tended to remain in situ longer, although possessing negligible rupture strength. The two materials were compared in suturing comeoscleral wounds of 45 consecutive patients undergoing routine cataract operation. The glycolactide began to disappear only after the fourth week, completely disappearing after nine weeks. Chromic collagen was more variable, some sutures disappearing as early as the third week, while others remained in place for over 20 weeks. Neither suture material excited reaction in the eyes, and the incidence of complications was low.

The effects of cosmic particle radiation on pocket mice aboard Apollo XVII: II. Characteristics and tolerances of the pocket mouse and incidence of disease

Pocket mice are facultative homoiotherms with the ability to drop their metabolic rate dramatically while at rest or in response to environmental stresses. Under these conditions, they characteristically enter a state of prolonged torpor. These animals require no drinking water and they can live in darkness for many months without apparent ill effect. They tolerate a wide range of ambient temperature, ralative humidity, and oxygen pressure and have survied without food for a mean of 14 d at an ambient temperature of 20 degrees C (68 degrees F). Studies carried out on the pocket mouse colony used for the Apollo XVII flight revealed, in the animals tested, no serological evidence of viral disease, no pathogenic enterobacteria or respiratory Mycoplasma on culture, a 25% incidence of sarcosporidiosis, and a 2% incidence of chronic meningitis or meningoencephalitis. The conclusion reached is that the pocket mouse is a highly adaptive animal and very well suited for space flight.