Search

Background: Endophthalmitis, a serious eye condition that poses a risk to vision and can quickly worsen, is considered a genuine urgent situation for the eyes. This research is concentrated on individuals with endophthalmitis who seek care in the emergency department (ED), with the objective of identifying the clinical signs and microbial properties that may increase the likelihood of needing evisceration. By doing so, the goal is to enhance the early detection and immediate management of this condition. Methods: This is a retrospective study conducted in the ED setting in a tertiary medical center in Northern Taiwan. Between January 2012 to December 2022, a total of 453 ED endophthalmitis patients were enrolled. Detailed chart reviews were done and the data collected included demographic characteristics, clinical symptoms, microbiology culture results, presenting visual acuity (VA), and the rate of evisceration. Results: There were 144 patients (31.8%) with endogenous endophthalmitis and 309 patients (68.2%) with exogenous endophthalmitis in the ED. The most common symptoms were blurry vision (94.3%) and red eye (88.7%). Blood culture was positive in 18.8% of cases, while vitreous or aqueous culture was positive in 59.6% of cases. The most commonly identified pathogens for endogenous and exogenous endophthalmitis were Klebsiella pneumoniae (20.5%) and Staphylococcus epidermidis (23.6%), respectively. The most significant risk factors for evisceration in both endogenous and exogenous groups were impaired initial VA and corneal ulcer. The proportion of patients with endogenous endophthalmitis who underwent evisceration (13.9%) was significantly higher than their exogenous counterparts (5.5%). Conclusions: Timely identification and proper management are essential for patients at risk of developing endophthalmitis in emergency settings. This is particularly important for individuals who exhibit compromised initial visual acuity and suffer from corneal ulcers. Despite intensive therapy, the long-term visual outcomes for endogenous endophthalmitis are generally worse compared to the exogenous form. [ABSTRACT FROM AUTHOR]

Highlights: The density of Parastichopus regalis increased from 50 to 107 m depth and subsequently decreased. No seasonal evisceration was observed. The organic matter content in the foregut was double the content in the sediment. Organic matter absorption efficiency during feeding was 16.64%. The P. regalis population may transit up to 13,855 kg wet weight of sediment y−1 km−2. Holothurians provide important ecosystem services by enhancing sediment health through bioturbation. The sea cucumber Parastichopus regalis has a wide distribution in the Mediterranean Sea. Even though it is a commercially exploited species, little is known about its ecological traits and there is no information on the bioturbation potential resulting from its feeding activity. To address these knowledge gaps, the population density, demographic structure, musculature and evisceration of P. regalis were investigated on Arenys de Mar, NW Mediterranean. Food assimilation efficiency, and feeding and bioturbation rates were assessed through field and laboratory experiments. The exploited population exhibited a healthy distribution of sizes/ages, and the density values were similar to or greater than those described in other Mediterranean areas. This species did not show seasonal evisceration, and seasonal patterns in muscle weight depended on year and body size. The field results indicated that P. regalis selected organic matter from the sediment as food. The average individual feeding rate was 8.6 g wet sediment d−1. The bioturbation role of the P. regalis population in the studied area was especially important at depths between 81 m and 124 m, where it consumed between 7.6 and 13.8 t of wet sediment y−1 km−2. These results highlight the important role that this species play in deep habitats as sediment bioturbator, controlling the accumulation of dead organic matter. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionsTo present a modified evisceration technique with a full-thickness horizontal sclerotomy and assess post-operative motility and long-term outcomes.This is a retrospective chart review of patients who underwent evisceration with a single surgeon (TJM). The standard initial steps of evisceration were performed. Before implant placement, a complete radial sclerotomy was extended posteriorly at the 3 and 9 o’clock positions, 2 mm above the optic nerve, longitudinally dividing the medial and lateral rectus insertions. The scleral halves were mobilized, allowing them to “swing” forward and overlap over the spherical implant. In a subgroup of five patients, postoperative motility was assessed by marking the conjunctiva overlying the implant and taking photos in extreme gazes. Operative and non-operative eye measurements were compared in SiliconCoach Digitizer Software.Thirty patients were identified (16 male, 14 female; mean age 56.9, range 4.6–90.1 years). Eleven patients were noted to have phthisis bulbi. Implant sizes were 18 mm (n = 13), 20 mm (n = 14), and 22 mm (n = 2) with a mean of 19.24 mm. Mean horizontal and vertical motility ratios of operated to non-operated eye were 0.61 ± 0.18 and 0.76 ± 0.28, respectively, with no statistically significant differences (p = 0.38).Evisceration with complete horizontal full thickness sclerotomy is an effective technique that prevents the sclera from limiting implant size, even in patients with phthisis bulbi. Longitudinal division of the recti insertions also did not affect function or implant stability. [ABSTRACT FROM AUTHOR]

Introduction: Burst abdomen can result in evisceration (protrusion of abdominal viscera), requiring immediate treatment. If, left untreated, it can cause perioperative mortality. Some studies have been conducted in the past to develop risk scoring systems to identify patients who have a significant risk of developing a burst abdomen. The Rotterdam score considers all three risk factors (i.e., preoperative, intraoperative, and postoperative) and is a standard scoring system for predicting the risk of burst abdomen in the Western population. The Krishna Institute of Medical Sciences (KIMS) 14 score compares only preoperative and intraoperative factors. Aim: To evaluate the demographic and clinical profile of patients developing burst abdomen following laparotomy for peritonitis and to assess their Rotterdam and KIMS 14 risk scores. Materials and Methods: This retrospective observational study was conducted in the Department of Surgery at GTB Hospital, New Delhi, India, from January 2024 to March 2024. The case sheet records of patients operated on in the last three years (January 2021 to December 2023) were evaluated. A total of 100 patients were enrolled as per inclusion and exclusion criteria. A total of 50 patients were classified as cases (who developed burst abdomen) and 50 patients as controls (who did not have burst abdomen). The outcome measures included demographic and clinical data of patients, associated co-morbidities, preoperative status, and intraoperative findings (organ affected, type of contamination, postoperative complications). The Rotterdam score and KIMS 14 score were calculated. For qualitative variables, the Chi-square test or Fisher's-exact test was used. Statistical significance was set at p<0.05. Results: Most subjects in the dehiscence group were males (40), and the rate was higher in the older age group (17 patients). The maximum number of dehiscences occurred postoperatively on day 6, with a mean of 6.66±2.66 days. The duration of surgery exceeding two hours was higher (80%) in the dehiscence group. The total leucocyte count (11074.00±6238.35 /mm3) and liver enzymes {Serum Glutamic Oxaloacetic Transaminase (SGOT) 68.72±58.90 U/L and Serum Glutamic Pyruvic Transaminase (SGPT) 68.22±75.62 U/L} were elevated in the dehiscence group. The incidence of Surgical Site Infection (SSI) in the postoperative period was higher (98%) in the dehiscence group. The mean Rotterdam and KIMS 14 scores were higher in patients who developed wound dehiscence (Rotterdam score of 5.05 and KIMS 14 score of 11.76) compared to patients who did not develop dehiscence (Rotterdam score of 3.73 and KIMS 14 score of 8.92). The p-values were 0.001 and 0.002 for the Rotterdam and KIMS 14 scores, respectively. Conclusion: Rotterdam and KIMS 14 scores were found to be statistically significant in patients developing burst abdomen. The mean score in both scoring systems was higher in patients who developed burst abdomen. [ABSTRACT FROM AUTHOR]

Sympathetic ophthalmia (SO) is a rare, bilateral, granulomatous, panuveitis following perforating trauma or surgical intervention in one eye. Here, and to the best of knowledge, we report the first case of SO following an evisceration surgery in Pakistan. A 32‐year‐old, Pakistani, female presented with pain and decreased visual acuity in her right eye, at Civil Hospital, Karachi, 1 week after an evisceration surgery was performed on her left eye, following corneal perforation due to unresolved keratitis. Diagnosis of SO was made on the basis of clinical presentation and confirmed by slit lamp examination which revealed mutton fat keratic precipitates, posterior synechiae, and optic disc swelling. She was administered high‐dose corticosteroids to which she did not respond. She was then prescribed methotrexate which resolved the inflammation and improved visual acuity. Initiating prompt treatment for the sympathizing eye led to effective management of the patient and prevented complete blindness. [ABSTRACT FROM AUTHOR]

Purpose: To describe the early health-related quality of life (HRQoL) of patients who have undergone an eye removal surgery. Methods: A descriptive monocentric study was conducted. Patients with a surgical indication of eye amputation were enrolled. Three standardized surveys were given to each patient 1–3 months after the surgery. The following standardized questionnaires were used: National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25) (range: 0–100), Short Form-36 (SF-36) (range: 0–100), and Perceived Stress Scale (PSS-10) (range: 0–40). Results: Between January 2021 and January 2022, in the Ophthalmology Department of the University Hospital of Besançon (France), 20 patients who were going to undergo an eye removal surgery were included. The population comprised a majority of men (12 men vs. 8 women) with a mean age of 70 (±16.2) years. The underlying conditions leading to the eye amputation were varied: three infections (15%), three retinal detachments (15%), three chronic uveitis (15%), 11 traumas (55%), three tumors (15%), and five chronic high intraocular pressures (25%). The surgical procedure consisted of an evisceration in 15 cases (75%) or an enucleation in five cases (25%). On average, the composite NEI VFQ-25 scored 68.7 (±22.4). Regarding the SF-36 score, the physical composite score was 63.1 (±15.4), and the mental composite score was 64.7 (±14.4). The overall PSS-10 score was 12.3 (±8.7). Conclusion: The patients who had undergone an eye amputation had an early reduction in their HRQoL in all its domains, especially in the vision, mental, and physical specific quality of life. These patients need personalized preparation before the surgery. These findings need to be assessed in the long term. [ABSTRACT FROM AUTHOR]

Purpose: To report a case of Purpureocillium lilacinum endophthalmitis. Methods: The case of a fungal endophthalmitis caused by Purpureocillium lilacinum documented in an immunocompetent patient with no apparent trigger. Results: A 64-year-old male with a two-month history of panuveitis in his left eye was referred to our hospital. Initially misdiagnosed as sympathetic ophthalmia due to a previous surgery on his right eye 4 months before the onset of the left ocular picture, the patient received corticosteroid treatment, leading to a rapid deterioration of the left eye condition. An urgent exploratory vitrectomy was performed to identify the underlying cause, revealing endophthalmitis. Microbiological investigation yielded Purpureocillium lilacinum as the causative agent. Despite intensive treatment, including intravitreal antibiotics and antifungals, along with another surgical intervention, clinical evolution remained unfavourable, ultimately leading to the evisceration of the affected eye. Conclusions: Purpureocillium lilacinum poses a rare yet sever threat as a causative agent of fungal endophthalmitis. Managing such cases is challenging due to the delayed identification, fungus's resistance to common antifungals, and its association with prior corticosteroid misuse in most patients. This case underscores the crucial importance of heightened clinical suspicion, early diagnosis, and the exploration of alternative treatment strategies in addressing Purpureocillium lilacinum endophthalmitis. The challenges posed by this rare fungal pathogen emphasize the need for a multidisciplinary approach and continued research to improve outcomes in these complex cases. [ABSTRACT FROM AUTHOR]

Congenital erythropoietic porphyria (CEP) is a rare autosomal recessive disorder in which the activity of uroporphyrinogen III synthase (UROS) is decreased. This results in the accumulation of photoreactive porphyrinogens, primarily in the skin and bone marrow. We describe a case of a patient with CEP who initially presented with scarring and shortening of the anterior and posterior lid lamella, which led to the development of lagophthalmos. Vascularized hyperkeratotic plaques in both corneas were also present. Despite treatment with topical ocular surface lubricants, corneal perforation with iris and uvea prolapse developed and evisceration of the right eye under local anesthesia was performed. The presented case suggests that despite topical therapy, ocular complications may exacerbate requiring surgical intervention, especially in the presence of lagophthalmos. [ABSTRACT FROM AUTHOR]

Objectives: Drusen are yellow deposits between the basal lamina of the retinal pigment epithelium and the inner collagenous layer of Bruch's membrane. Soft drusen, generally characterized by a medium to large size and poorly demarcated boundaries, increases the risk for advanced age-related macular degeneration (AMD). The prevalence of soft drusen in histopathological sections of the macular region, obtained from enucleated and eviscerated eyes, will be correlated in this study. Materials and Methods: This is a prospective cross-sectional study performed at the MUHC-McGill University Ocular Pathology and Translational Research Laboratory (McGill University, Montreal, Canada). A total of 158 eyes were evaluated between 2011 and 2019. Of these, 50% were enucleated and 50% eviscerated eyes. Cases were divided by age in decades into both groups, eviscerated and enucleated eyes. Inclusion criteria were patients aged 50 years or older, identification by histological criteria of macular area, histopathologically preserved macular area, presence of sufficient residual tissue for additional sections, and concrete patient data. The histopathological review was performed in digitized H and E slides (ZEISS Axio Scan.Z1) to assess the presence of soft drusen. Results: The results in both groups, enucleated and eviscerated eyes, were similar, as well as the histopathological criteria used in the analysis of soft drusen. Conclusion: Prevalence of AMD in the referred population was comparable to that described in both studied groups. [ABSTRACT FROM AUTHOR]

Uterine perforation is a major but rare complication of surgical abortion. Some of the dreaded complications are bowel herniation, strangulation, gangrene, and sepsis. With the legalisation of medical termination of pregnancy, such life-threatening complications have become a rarity in recent times. Usually, the patient presents with lower abdominal pain. A history of surgical abortion may not be forthcoming if an unsafe abortion is performed. A high index of suspicion should be kept while imaging such patients in an emergency setting, since early diagnosis is the key to survival. Hereby, the authors present a case of a 30-year-old female patient presenting with non specific complaints of abdominal pain. Upon vaginal examination, a structure protruding out of the internal os (admitting the tip of a finger) was noted, and a boggy mass was felt in the pouch of Douglas. Ultrasonography and Contrast-enhanced Computed Tomography scan (CECT) performed in an emergency setting revealed uterine rupture with a rent, intra-abdominal foetal extrusion, and bowel loop herniation through the vagina. A delayed CT scan provided additional information about right ureteral injury, which was helpful in proper urological preoperative planning. In conclusion, ultrasonography and CECT imaging are useful in cases with lower abdominal pain having recent history of abortion to rule out uterine perforation and other obvious and occult associated complications for proper patient management. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the short-term efficacy of cyclocryotherapy in pain control in 63 patients with absolute glaucoma who had pain and no vision despite maximum medical treatment. Methods: 63 eyes of 63 glaucoma patients defined as absolute glaucoma were included in the study. The intraocular pressures, number of drops used, pain status and need for recurrent therapy were compared before and after the procedure at 1 and 3 months Results: 13 of the patients were female and 40 were male. The mean age was 59.4±17.5 years. 50 of the patients were diagnosed with neovascular glaucoma, 3 with congenital glaucoma, 1 with primary open-angle glaucoma and 9 with angle-closure glaucoma. Preoperative mean intraocular pressure was 50.7±12 mmHg, while it was found to be 37.9±15.4 mmHg in the 1st month and 28.5±15.8 mmHg in the 3rd month postoperatively. The decrease in intraocular pressure before and after the procedure was statistically significant at 1 and 3 months. (p<0.0001) Pain control was received 85% at the first month and 96% at the third month after the procedure. Number of medications that were used was found 3.00 and 2.3±0.9 respectively before and after the procedure and this was statistically significant. (p<0.0001) While no phthisis was observed in any patient, evisceration was applied to 2 patients because of uncontrolled pain. Conclusion: Cyclocryotherapy may be a preferred treatment option before evisceration, as it is a non-invasive, inexpensive and easily applicable method in patients whose pain control cannot be achieved, although it has lost its former popularity with the discovery of new options in the surgical and medical treatment of glaucoma [ABSTRACT FROM AUTHOR]

Summary: Despite castration being one of the most frequently performed elective equine surgical procedures, complication rates are high and range from severe life‐threatening conditions to mild complications that are of no consequence to the horse. This article will briefly review strategies to prevent complications and surgical castration techniques before reviewing, in‐depth, the following complications: excessive scrotal swelling and seroma formation, scrotal infection, septic funiculitis, septic peritonitis, haemorrhage, evisceration, omental prolapse, pyrexia, tetanus, penile trauma, hydrocele, signs of colic and continued stallion‐like behaviour. Whilst this list of complications can be daunting, an understanding of male anatomy, castration techniques and an awareness of possible complications can reduce both the incidence and mortality of complications, should they occur. This article will consider castrations performed in both a hospital and field setting and will review complication prevention, surgical techniques of castration and the management of intraoperative and postoperative complications. [ABSTRACT FROM AUTHOR]

This study examines three of the most iconic sites associated with Islamic mysticism, or Sufism, in Ottoman Hungary. These are three mausoleums located in Buda, Pécs, and Turbék, near Zigetvár. The first two are the final resting places of the Sufi mystics known as Gül Baba and Idris Baba. The third is Sultan Süleyman's mausoleum next to a Sufi dervish lodge, the foundations of which were uncovered during recent excavations. The research sheds light on the (embodied) material practices associated with these sites, as well as their sensory engagement and synaesthetic experiences. The bodies of the spiritual leaders, presented in the first two cases, serve as living sites of mystical experiences, both through self-destructive acts graphically represented on their bodies, and through bodily miracles such as hypercorporeality, multilocality, and dream visions. The third case concerns the body of a secular and a spiritual leader, the temporary burial of his disemboweled and embalmed body in the mausoleum at Turbék, and the tradition that his heart and entrails were kept in a reliquary-like vessel at the site, which interestingly paralleled contemporary Habsburg customs. Building on Thomas Csordas (1990) and Manuel Vásquez (2011), I explore the role of human and non-human "supernatural" actors interacting in these mystical networks, focusing on the role of their embodiment and materiality, their movement and their physically fragmented bodies. [ABSTRACT FROM AUTHOR]

To present an alternative evisceration technique with long-term follow-up data. This technique involves the insertion of an acrylic implant into a modified scleral shell which is closed using an autologous scleral graft. This was a retrospective analysis of eviscerations performed in a district-general hospital in the UK. All patients underwent conventional ocular evisceration after total keratectomy. A full thickness scleral graft is harvested from the posterior sclera, using an internal approach, with an 8 mm dermatological punch. An 18–20 mm acrylic implant is placed into the shell, and the scleral graft is used to close the anterior defect. Demographic characteristics, implant size and type, and cosmetic results from pictures of all patients were recorded. All patients were invited for a review to measure motility, eyelid height, patient recorded satisfaction and complications. Of the five patients identified, one had since died. The remaining four attended a review in person. The mean time between surgery and review was 48 months. The mean implant size was 19 mm. There were no cases of implant extrusion or infection. All four had a <1 mm asymmetry in measured eyelid height and ≥5 mm horizontal gaze motility. All patients self-reported "good" cosmesis. An independent assessment identified "mild asymmetry" in two cases and "moderate" in the other two. Evisceration with this novel autologous scleral graft technique restores volume in the anterior orbit with good cosmetic results, and with no cases of implant exposure reported in this small case series. This technique should be compared prospectively to established techniques. [ABSTRACT FROM AUTHOR]

Transvaginal small bowel evisceration is a life-threatening condition, which is usually seen in postmenopausal women with a history of gynecological surgery. Cervical loop electrosurgical excision procedure (LEEP) is widely used in the treatment of cervical intraepithelial neoplasia (CIN), and its surgical risk and postoperative complications are relatively low because of the simplicity of the operation. However, improper operation may result in perforation of the uterus, which can cause prolapse of the small bowel into the vagina. We here reported an extremely rare case of a young woman with transvaginal small bowel evisceration after cervical LEEP, achieving a good prognosis after the prolapsed bowel was reduced. The patient underwent cervical LEEP as a treatment for CIN III, but the LEEP resulted in a laceration of about 4.0 cm × 3.5 cm on the peritoneum of the uterovesical peritoneal reflection and a laceration of about 2.0 cm × 1.5 cm on the anterior wall of the cervical canal. Through the two lacerations, the pelvic cavity is connected to the vagina and the small intestine prolapsed into the vagina. Due to aggressive surgical intervention, the patient achieved a favorable prognosis after successfully reducing the prolapsed bowel. [ABSTRACT FROM AUTHOR]

Objective: Four Petal Evisceration Inphthisical Eyes. Study Design: Retrospective Study. Place And Duration of Study: Armed Forces Institute Of Ophthalmology, Rawalpindi Pakistan, from Jan 2022 to Apr 2022. Methodology: A total of 20 subjects underwent evisceration with four petal technique. The record was collected from record room and data was analyzed. After 360° conjunctival peritomy, a larger orbital implant was placed for good cosmesis and to achieve maximum ocular motility. Axial length (AL) of normal eye was measured and compared with AL of atrophic eye. An orbital implant 3mm smaller than the axial length of the normal eye was placed. Implant was closed with 4 coverings to prevent extrusion. SPSS version 22.0 was used for data analysis. Results: Out of n=20 patients with atrophia bulbi, females 11(55%) and males 9(45%). About 12(60%) were right eyes and 08(40%) were left eyes. Mean SD age of patient was 35.1±17.01 years. An implant of 18mm, 20mm and 22mm were used after calculation of axial length. Axial length of normal eye was used for the selection of size of implant. However, follow up was done from 4-18 months respectively. Conclusion: Evisceration with four petals remains the procedure of choice due to better cosmesis and good motility. [ABSTRACT FROM AUTHOR]

This study investigated the response of cultured Holothuria atra, a sea cucumber species inhabiting the Red Sea's Egyptian coast off Hurghada City, to thermal and salinity stressors. It aimed to identify the growth, survival rates, and physiochemical adaptations of H. atra to understand their potential for aquaculture in the region. The study used a range of experimental manipulations to expose the species to different temperature and salinity conditions, measuring key physiological responses such as respiration rate, execration rate, and growth rate. The results suggested that thermal and salinity stressors significantly impacted H. atra, with growth rates decreasing and physiological function disrupted under extreme conditions. As revealed, temperature and salinity variations harm the H. atra growth as it showed a noticeable decline under any deviation from their typical temperature and salinity conditions. The species also exhibited some adaptive responses, i.e., evisceration, regeneration (autotomy), and survivorship. Overall, the study offers important insights into the potential for sea cucumber aquaculture in the Red Sea, highlighting the need for careful management of environmental conditions to maintain optimal health and growth. [ABSTRACT FROM AUTHOR]

Vaginal cuff dehiscence (VCD) is a rare but serious condition associated with high morbidity, especially in the presence of an evisceration. It usually occurs as a complication of hysterectomy, but has also been reported after other pelvic surgeries. In this article, we will present two cases of vaginal cuff dehiscence with evisceration in post-menopausal patients. Both cases occurred post-operatively, the first after a laparoscopic radical hysterectomy and the other after a trachelectomy performed by robotic-assisted laparoscopy (with a prior history of subtotal hysterectomy). Both cases were treated surgically, the first by a combined laparoscopic and vaginal approach, and the second case only by laparoscopic approach. The main risk and protective factors are discussed in a narrative literature review which summarizes the available evidence on this rare condition, discussed by type of study designs and thus evidence level. A laparoscopic vaginal cuff closure is the most protective factor in preventing VCD, compared to a vaginal closure. Clinicians should be aware of this condition and of its risk factors and precipitating events in order to identify high-risk patients. Knowledge of these allows prompt recognition, which is crucial for adequate management, for which multiple approaches have been described. [ABSTRACT FROM AUTHOR]

Purpose: To identify clinical risk factors for enucleation or evisceration in patients with endophthalmitis at an academic institution. Methods: A retrospective review of patients diagnosed with endophthalmitis at Wilmer Eye Institute from 2010 to 2019 was conducted. Clinical characteristics, including demographics, cause for endophthalmitis, microbial culture results, salvaging procedures and surgical intervention were recorded. In patients who underwent enucleation or evisceration, type of surgery and placement of a primary implant were recorded. Chi-squared, Student's t-tests and multivariate analysis were used to identify clinical factors that predicted enucleation or evisceration. Results: Two hundred and fifty three patients treated for endophthalmitis over the study period were identified, of which 25 (9.88%) underwent enucleation or evisceration. Risk factors for enucleation or evisceration included poor presenting visual acuity (OR 7.86, CI: 2.26, 27.3), high presenting intraocular pressure (OR 1.07, CI: 1.03, 1.12), presence of relative afferent pupillary defect (OR 3.69, CI: 1.20, 11.37) and positive vitreous culture for methicillin-resistant staphylococcus aureus (MRSA) (OR 18.3, CI: 1.54, 219.2) on multivariate analysis. Patients undergoing enucleation or evisceration were also more likely to have trauma, corneal ulcer or combined causes for endophthalmitis and underwent fewer salvaging surgical and procedural interventions. There were no significant differences in characteristics of those receiving enucleation versus evisceration in our cohort. Conclusion: Patients with endophthalmitis who underwent enucleation or evisceration had more severe disease on presentation compared to those treated with eye sparing therapy. Presenting clinical characteristics may have a role in triage and management decisions for patients presenting with severe endophthalmitis. [ABSTRACT FROM AUTHOR]

Painful-blind eye (PBE) is a challenging and debilitating condition that greatly affects the quality of life of patients. Although PBE can result from a variety of etiologies, currently there is no guideline or consensus on how to approach therapeutically these patients, and most treatments are experience-based. We summarized the evidence from available studies to investigate the current state of PBE treatment strategies. This review revealed that the information available about therapeutic approaches in patients with PBE is insufficient and outdated, therefore, new experimental and larger studies are needed to reach an agreement about this condition. [ABSTRACT FROM AUTHOR]

The present article reports on the management of six different and rare cases of fungal keratitides, two of which have never been documented in previous literature. This is a case series of six patients with rare fungal keratitides managed at a quaternary eye referral unit, Sydney Eye Hospital, Australia over a period of 7 months (May to December, 2022). The order of occurrence of fungi isolated was Scedosporium apiospermum, Lomenstospora prolificans, Cladosporium spp., Paecilomyces, Syncephalastrum racemosum and Quambalaria spp. A combination of medical and surgical interventions was employed, including topical and systemic anti-fungal therapy, with one requiring therapeutic penetrating keratoplasty and another eventuating in evisceration. Two patients were successfully treated with corneal debridement and two others required pars plana vitrectomy with anterior chamber washout. It is important to remain vigilant with monitoring patient symptoms and correlating with clinical signs to guide antifungal therapy even in the context of confirmed culture and sensitivity results. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the results of all eviscerations and enucleations performed at the Department of Ophthalmology, Sahlgrenska University Hospital, during 2008–2019 and to compare them with previously collected data from 1999 to 2007. This was a retrospective investigation using the medical records for all patients having had an evisceration or an enucleation at the Department of Ophthalmology, Sahlgrenska University Hospital, during the two defined periods of time. Main outcome measure was postoperative complications. During 1999–2007, 181 surgeries were performed, 100 with implants, and 28/100 exposed implants and 9/100 removed implants were recorded during follow-up. During 2008–2019, 250 operations were performed with 158 implants, and there were 3/158 exposed implants and 2/158 extruded implants. Two ruptures of the surgical wound without implant exposure were noted, and one implant was exchanged. The reduction of exposed implants between the two periods was statistically significant (p <.001, Chi-square test). In enucleations, the use of one kind of porous polyethylene implant in the recent study period replaced a multitude of implants in the earlier study period. In eviscerations, the major change between the two study periods was the introduction of the split sclera technique and smaller implant size. The change in surgical technique between the two periods led to a significant reduction in implant-related complications. [ABSTRACT FROM AUTHOR]

After eye loss, a fast supply with a visually appealing prosthetic eye is not just a cosmetic solution, it is the key factor for a successful social, occupational, and psychological rehabilitation. For a long time, prosthetic eye care was based on acquired experiences, and there was a significant lack of systematic studies and peer-reviewed literature on this subject. However, in recent decades, research in the field of ocular prosthetics has been driven forward by ophthalmologists, ocularists, optometrists, ophthalmoplastic surgeons, and psychologists. Many essential findings have been made for improving the care of anophthalmic patients. In this extensive review, the current state of the art regarding prosthetic eye care based on the newest scientific findings is summarized. The broad focus includes important historical aspects in ocular prosthetics, in particular the historical development that led to ocularistic care with different prosthetic materials – cryolite glass and polymethyl methacrylate. Furthermore, epidemiology and etiology of eye loss, surgical techniques of eye removal as well as types and production of prosthetic eyes are set out. Important topics with new insights include psychological issues such as living with a prosthetic eye, treatment of children with anophthalmia and microphthalmia, as well as evidence-based prosthetic eye maintenance and handling. In addition, anophthalmic socket complications and associated treatment options with a focus on the common dry anophthalmic socket and post-enucleation socket syndromes were described in detail. Finally, we will speculate how the field of prosthetic eye care will develop in the future. • Prosthetic eye care is the key factor for successful rehabilitation after eye loss. • Successful psychosocial rehabilitation is essential for anophthalmic patients. • Treatment of children with anophthalmia is important to avoid appearance concerns. • Evidence-based maintenance of prosthetic eyes can avoid unwanted socket responses. • The dry anophthalmic socket syndrome is a relevant life-affecting issue. [ABSTRACT FROM AUTHOR]

Purpose: To compare tear film osmolarity (TFO) values and matrix metalloproteinase 9 (MMP-9) levels between anophthalmic sockets and healthy fellow eyes and to assess the use of the MMP-9 and TFO as objective biomarkers for the dry anophthalmic socket syndrome (DASS). Methods: In this prospective single-center study, the anophthalmic sockets and healthy fellow eyes of 98 unilateral anophthalmic patients were assessed using the ocular surface disease index (OSDI) questionnaire, InflammaDry® MMP-9 point-of-care immunoassay, TFO with TearLab™ Osmolarity System, and clinical conjunctival inflammation. MMP-9 concentration and conjunctival inflammation were graded semi-quantitatively. Differences between anophthalmic sockets and the healthy fellow eyes for OSDI scores, MMP-9, TFO values, clinical conjunctival inflammation, and eyelid abnormalities as well as the correlation between these factors and demographic data were evaluated. Results: Patients had significantly higher OSDI, MMP-9, and TFO values, as well as higher conjunctival inflammation on the anophthalmic side, compared to the healthy side (p ≤ 0.002, respectively). For anophthalmic sockets, there was a significant positive correlation between OSDI scores and TFO values (p = 0.007), between the grade of posterior blepharitis and TFO values (p = 0.026), and between the conjunctival inflammation and MMP-9 values (p < 0.001), as well as between MMP-9 levels and time since eye loss (p = 0.004). Conclusions: Measuring MMP-9 and TFO may be helpful tools as efficient, quantifiable biomarkers, disease course parameters, or predictors for treatment response in the clinical management of patients with DASS or future therapy studies. Ophthalmologists should consider the updated diagnosis criteria including TFO and the definition for DASS proposed in this study. [ABSTRACT FROM AUTHOR]

Describe presumed microbial keratitis cases resulting in evisceration/enucleation from 2012 to 2016 in Sydney, Australia A retrospective case review included 33 patients. Cases were identified from pathology and hospital coding data. Sociodemographic and clinical details were collated. Mean age was 79 years (range: 38–100 years), and 64% female. There were 30 eviscerations and 3 enucleations, at a median time of 8 days (range: 1–270 days) due to endophthalmitis (n = 15, 45%). Major ocular associated factors included topical corticosteroid use in 12 patients (36%), exposure keratopathy in 4 (12%), ectropion in 3 (9%), degenerative corneal disease in 3 (9%), and corneal graft in 2 (6%). Pseudomonas aeruginosa was the most common isolate with no reports of antimicrobial resistance. Educating elderly patients with a history of topical corticosteroid use, corneal or ocular surface disease about prompt hospital presentation and treatment of microbial keratitis may decrease the probability of losing the eye. [ABSTRACT FROM AUTHOR]

To describe the surgical outcomes and implant complications in 1,800 patients undergoing evisceration with primary implant An Electronic Medical Record-driven analysis of 1,800 patients undergoing evisceration with primary implant between 2013 and 2019. Implant sizing was performed intra-operatively to place the largest implant without tension on the wound closure. Outcome measures included implant complications, prosthesis measurements, and incidence of a good aesthetic outcome. Good outcome was defined as <2 mm enophthalmos and grade 1 or less superior sulcus deformity with a custom ocular prosthesis. Eighteen hundred eyes of 1800 patients were included. The mean age at surgery was 36 ± 21 years (median 32 years). Implants used were poly(methyl methacrylate) (PMMA) in 1737 (97%) and porous polyethylene in 63 (3%) patients. Two-petal sclerotomy was performed in 1512 (88%) and four-petal sclerotomy in 165 (10%) patients. The mean diameter of the implant used was 19.35 ± 1.18 mm (median 20, range 10–22 mm). The implant extrusion rate was 3% (56) and implant displacement was seen in none. The mean prosthesis volume and thickness were 2.22 ± 0.67 ml (median 2, range 1–6.5 ml) and 6 ± 1 mm (median 6, range 2–9 mm). The mean difference in prosthesis projection on Hertel's exophthalmometer was 0.28 ± 1 mm (median 0, range 0–1 mm). Good outcome was observed in 93%. The mean follow-up period was 351 ± 386 days (median 194). Evisceration with empirically selected primary orbital implant placement is associated with minimal implant complications and gives a good aesthetic outcome in 93% of the patients. [ABSTRACT FROM AUTHOR]

Purpose: Abdominal wall injuries (AWI) is a clinical and radiological diagnosis of fasciomuscular and at times cutaneous defects after abdominal trauma. Their severity encompasses a spectrum of parietal defects, with the most severe being a burst abdomen with eviscerated organs. With the wide use of CT scans in trauma settings, their incidence is being more recognized. Especially in severe AWI, where associated intrabdominal lesions are highly prevalent, many questions about parietal reconstruction arise concerning the timing and type of surgery, and their final hernia recurrence rate. Method: A list of severe AWI injuries have been retrieved, all of which were treated in our center. Type of trauma, clinical presentation, surgical technique and follow-up have been included. Results: Eight cases were found with severe abdominal injuries, with an age range of 11–85 years. Road traffic accidents, crush injuries, fall from height, stab and gunshot wounds are included. Seven out of the 8 cases had associated intrabdominal traumatic lesions. Mesh augmentation due to tissue loss was used in three cases. Recurrence rate was estimated around 25%. Conclusion: Prompt surgical exploration is required as associated intrabdominal traumatic lesions are highly associated with severe AWI. Even when intrabdominal lesions are ruled out, fasciomuscular defects should be managed during the same hospitalization, to prevent intestinal strangulation and occlusion. Mesh augmentation should only be used when parietal defects include extensive tissue loss preventing tension-free parietal reconstruction. [ABSTRACT FROM AUTHOR]

Aim The aim of this work was to evaluate the effectiveness of modified evisceration technique compared with standard technique in cases associated with deficient sclera. Patients and methods A prospective interventional study was conducted that included 34 eyes of 31 patients with deficient sclera scheduled for modified evisceration technique with intraconal placement of nonporous acrylic implants. Outcome was assessed in terms of implant extrusion, exposure, as well as other early or late postoperative complications. Results Adequate volume replacement was achieved in 32 (94.12%) of 34 eyes. Overall, two (5.88%) eyes had mild upper sulcus deficit, and three (8.8%) eyes had mild to moderate prominence of the prosthesis compared with the fellow eye, but no true exposure, extrusion, migration, socket contracture, or sympathetic ophthalmia was encountered. All of the patients were satisfied with the cosmetic and functional outcomes of the procedure, except for the two (5.88%) cases with upper sulcus deficit. Conclusion A modified evisceration technique for deficient sclera provides superior cosmetic and functional results compared with the standard technique. It has the advantage of allowing placement of relatively large orbital implants in cases associated with insufficient sclera with very low rates of implant extrusion, exposure, migration, or socket contracture. [ABSTRACT FROM AUTHOR]

Keywords: Dry anophthalmic socket syndrome; Tear film osmolarity; Matrix metalloproteinase 9; Enucleation; Evisceration; Conjunctival inflammation; Anophthalmic socket surface inflammation EN Dry anophthalmic socket syndrome Tear film osmolarity Matrix metalloproteinase 9 Enucleation Evisceration Conjunctival inflammation Anophthalmic socket surface inflammation 2713 2715 3 08/18/23 20230901 NES 230901 Graph The editorial I How to analyze conjunctival inflammation in dry anophthalmic socket syndrome (DASS)? Dry anophthalmic socket syndrome, Tear film osmolarity, Matrix metalloproteinase 9, Enucleation, Evisceration, Conjunctival inflammation, Anophthalmic socket surface inflammation Novel point-of-care biomarkers of the dry anophthalmic socket syndrome: tear film osmolarity and matrix metalloproteinase 9 immunoassay. [Extracted from the article]

The Polian vesicle is the main accessory structure in the water vascular system of sea cucumbers. It can function to hold water vascular fluid under slight pressure and act as a hematopoiesis, excretory, and inflammatory response organ. Being the only organ to remain after evisceration, the Polian vesicle may function in the survival and regeneration of sea cucumber. We performed Tandem Mass Tag (TMT)-based proteomics to identify how proteins in the Polian vesicle of Apostichopus japonicus respond to evisceration. Among the 8 453 proteins identified from vesicle samples before evisceration (PV0h) and at 6-h post-evisceration (PV6h) and 3-d post-evisceration (PV3d), we detected 222 differentially abundant proteins (DAPs). Most of the annotated DAPs were associated with cell growth and proliferation, immune response and wound healing, substance transport and metabolism, cytoskeleton/cilia/flagella, extracellular matrix, energy production and conversion, protein synthesis and modification, and signal recognition and transduction. Compared with PV0h, fewer DAPs were identified at PV6h, and more DAPs were found at PV3d, and these DAPs were widely distributed among multiple biological processes. Our results indicate that a wide range of biological processes was induced in Polian vesicles in response to evisceration. In particular, Polian vesicles may play important roles in the restoration of coelomocytes, immune defense, and wound healing in sea cucumber. We propose that the Polian vesicle may be involved in visceral regeneration through nutrition and energy supply and by promoting dedifferentiation and migration. Together, these results provided new insights into the function of the Polian vesicle in A. japonicus post-evisceration. [ABSTRACT FROM AUTHOR]

Simple Summary: Many species of sea cucumber in Echinodermata may eviscerate most of or even all internal organs when encountering predators or adverse environments, and can achieve regeneration within a certain time. Although regeneration time varies, the mechanism is common. This paper reviewed the intestinal regeneration process of sea cucumbers from the perspectives of histocytology and molecular mechanism. Echinodermata has a special evolutionary position between achordate and chordate, so we hope to explore the common regeneration conserved signals between invertebrates and vertebrates by recording the intestinal regeneration of sea cucumbers. Most species of the class Holothuroidea are able to regenerate most of their internal organs following a typical evisceration process, which is a unique mechanism that allows sea cucumbers to survive in adverse environments. In this review, we compare autotomy among different type of sea cucumber and summarize the histocytological events that occur during the five stages of intestinal regeneration. Multiple cytological activities, such as apoptosis and dedifferentiation, take place during wound healing and anlage formation. Many studies have focused on the molecular regulation mechanisms that underlie regeneration, and herein we describe the techniques that have been used as well as the development-related signaling pathways and key genes that are significantly expressed during intestinal regeneration. Future analyses of the underlying mechanisms responsible for intestinal regeneration should include mapping at the single-cell level. Studies of visceral regeneration in echinoderms provide a unique perspective for understanding whole-body regeneration or appendage regeneration. [ABSTRACT FROM AUTHOR]

Stercoral ulcers are localized areas of loss of colonic mucosal integrity. They result from pressure necrosis of the colonic mucosa, secondary to chronic constipation and fecal inspissation. These ulcers are rare and, are associated with serious complications, including bleeding and perforation. We present the case of a 50-year-old woman who presented with small bowel evisceration through the anal canal secondary to extraperitoneal perforation of the rectum. The patient underwent emergent exploratory laparotomy with reduction of the bowel, followed by second look laparotomy in 24 hours. A full thickness defect in the rectum was identified and Hartmann's procedure was performed. The patient's postoperative course was uneventful. Extraperitoneal perforation and evisceration of bowel is a rare clinical entity. These cases are diagnosed early due to the obvious clinical presentation and however may be misdiagnosed as prolapse. They necessitate urgent and careful surgical planning, to ensure preservation of bowel and complete recovery. [ABSTRACT FROM AUTHOR]

Endophthalmitis treatment consists of intravitreal antibiotics injections and, in selected circumstances, pars plana vitrectomy. However, severe or refractory cases may require an enucleation or evisceration (ENEV). Our study seeks to identify risk factors leading to enucleation or evisceration in patients with infectious endophthalmitis. A retrospective chart review of subjects with a clinical diagnosis of infectious endophthalmitis was undertaken. The affected eyes were stratified into groups: those that underwent ENEV and those in which the eyeball was preserved (EP). The groups were compared using statistical analyses. In total, 69 eyes diagnosed with infectious endophthalmitis were included in the study. There was a higher frequency of exogenous infectious endophthalmitis in the ENEV group versus the EP group. Postsurgical infectious endophthalmitis was lower in the ENEV than in the EP group. A visual acuity of no light perception was more common in the ENEV compared to the EP group. Panophthalmitis was more frequent in the ENEV versus the EP group. Our findings suggest that eyes with endophthalmitis presenting with a visual acuity of no light perception, panophthalmitis, or exogenous etiology have a higher risk of requiring ENEV. In addition, eyes with a postsurgical etiology may be at a lower risk of requiring ENEV. [ABSTRACT FROM AUTHOR]

Fungal keratitis, an infective disease of the cornea, represents a serious diagnostic and therapeutic problem that, if not recognized on time, could lead to irreversible eye damage. Herein we report a case of fungal keratitis due to Fusarium spp. infection. The 60-year-old man was admitted to our clinic due to an atraumatic acute onset of the disease, with a decrease in the visual acuity, photophobia, redness, and severe pain in the right eye. Clinical observation revealed an ulcer that affected 1/3 of the cornea and a hypopion in the anterior chamber. After the first results of microbiological analyzes, local and systemic antifungal therapy was applied. Due to the fact that the patient voluntarily left the treatment, there was a drastic worsening of the local findings as a full thickness total corneal infiltrate with more intense anterior chamber reaction. Finally, evisceration was performed. Given the fact that fungal keratitis is more prevalent in developing countries, official protocols and available effective antifungals are crucial for adequate treatment and a favorable outcome of this infection. [ABSTRACT FROM AUTHOR]

Vaginal vault dehiscence with evisceration is a rare but a potentially life-threatening complication of total hysterectomy that requires prompt recognition, diagnosis, and management. The overall incidence of vaginal vault dehiscence is 0.53%. The mortality rate increases to 5.6% when bowel evisceration is present. We report a case of vaginal vault dehiscence with small bowel evisceration complicated by bowel necrosis and intra-abdominal haemorrhage in a 48-year-old woman following her first sexual intercourse 4 months after her total abdominal hysterectomy. [ABSTRACT FROM AUTHOR]

To describe the presentation and clinical course of a case of endogenous endophthalmitis caused by Clostridium septicum, an anaerobic and gram positive bacteria. Observational report of a clinical case presented in Spain. A 61-year-old male patient was referred to our hospital with a diagnosis of endophthalmitis of his left eye since ten days prior to presentation, and a history of poor response to medical treatment. Evisceration was performed, and C. septicum was isolated from a sample of the vitreous humor. Fourteen days after surgery, the patient returned with orbital cellulitis, and exenteration was performed. Forty-two days after initial presentation, colonoscopy revealed an adenocarcinoma of the proximal colon. Surgical resection of the tumor was performed, and clinical recovery was achieved. iSystemic C. septicum infection without a traumatic cause has been associated with malignancy, although an initial presentation of endophthalmitis has rarely been reported. In cases of clostridial endogenous endophthalmitis, investigation for colorectal carcinoma is indicated. [ABSTRACT FROM AUTHOR]

A 29-years-old Turkish man who had undergone evisceration with primary orbital implantation 20 months prior complained of difficulty wearing his artificial eye. Slit-lamp examination revealed a conjunctival cyst in the center of the anophthalmic socket, with no evidence of scleral or orbital implant exposure. The cyst was completely excised under general anesthesia and did not require use of any sclerosing substance or dye. At 6 months postoperatively, there was no recurrence of the cyst or exposure of the sclera or orbital implant. As the upper and lower fornices were sufficiently deep, the patient could wear his artificial eye. [ABSTRACT FROM AUTHOR]

The disapproval of broiler carcasses in slaughterhouses leads, directly, to losing quality and quantity of produced meat, to compromising the production line efficiency and causing processing additional costs. The carcasses can be partially or completely condemned, due to numerous causes. The identification of carcasses condemnation causes and the analyses of its factors enables to minimize losses and the improvement of the slaughter process. Thus, this research aimed to: identify the causes of total broiler carcasses condemnation, by utilization of quality tools, and elaborate an action plan that would reduce the total condemnation of broiler carcasses. The study was carried out in a slaughterhouse located in the western region of the state of Paraná. It was noted that the main cause of broiler carcasses condemnation was contamination (57.0%). The factors related with the contamination of broiler carcasses were the lack of uniformity in the weight of the broilers, the inappropriate pre slaughter fasting time, flaw in the regulation of cloaca's extracting machine, abdomen cutter and viscera extracting machine and the poor staff training. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the safety and effectiveness of 2% subconjunctival injection of Fluconazole as an adjunctive treatment in severe recalcitrant fungal keratitis. Study Design: Interventional case series. Place and Duration of Study: Ophthalmology department of Holy family hospital, Rawalpindi medical university, from January 2019 to August 2019. Methods: The study included 18 eyes of 18 patients with severe resistant fungal corneal ulcer. We excluded those cases who had known hypersensitivities to Fluconazole. These ulcers were refractory to primary conventional antifungal therapy with topical Natamycin, topical and systemic Fluconazole. Sample for culture was taken with sterile cotton bud and scraping was taken with kimura spatula. All resistant cases were given1.0 ml of 2% subconjunctival Fluconazole injection once a day for at least one week. After that depending upon the condition, the injections were given on alternate days for 2 weeks. Results: Average age of the patients was 35.22 years (SD ± 10.42). Among total 18 patients, six (33.33%) were females and 12 (66.67%) were males. Thirteen (72.22%) cases showed absolute response after one week and 5 (27.77%) cases needed more injections. Four (22.22%) of these 5 cases partially improved and one case failed to show improvement. Final vision varied in different cases according to the position of the residual scar. Five cases ended up in keratoplasty. Local or systemic toxicity was not seen in any case. Conclusion: Subconjunctival injection of 2% Fluconazole can be used as an adjunctive therapy for severe fungal keratitis without any toxic complications. [ABSTRACT FROM AUTHOR]

Purpose: To assess factors associated with visual outcome after open-globe injury (OGI) repair by trainees. Methods: In this observational study, charts of OGIs repaired by trainees at King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok were retrospectively reviewed. Preoperative, intraoperative, and postoperative outcomes (day 1, month 1, and month 6 postoperation) were analyzed. Results: A total of 78 OGIs presented in a 10-year period. A biphasic pattern was found among the young and the elderly. Approximately 73.6% of the cases had had surgical repair outside office hours. A majority of cases had been caused by machinery and hammers, and had visual acuity (VA) < 20/200. Three cases were reported as having been unsuccessful intraoperatively for globe repair. A fifth of the cases required evisceration/enucleation within 2 weeks of presentation. Presenting VA worse than hand motion was associated with the risk of evisceration/enucleation (OR 14.5, P=0.013). VA improved at 6 months postoperation to the range of counting fingers and 20/200 (OR 15.6, P< 0.01). High ocular trauma scores (OTSs) was associated with lower risk of evisceration/enucleation, and 12% retinal detachment (RD) was discovered, of which 90% occurred within 1 month after OGI repair. Conclusion: Most OGIs were efficiently managed by the trainees, seldomly requiring assistance from subspecialists. Poor initial VA was associated with high risk of visual loss, whereas higher OTSs were inversely related to lower risk of evisceration or enucleation. There was a higher percentage of participants with final VA of 20/100– 20/20 than the preoperative period. Precaution and careful evaluation of RD in the early postoperative period is recommended. [ABSTRACT FROM AUTHOR]

In the present study, the regeneration process following posterior evisceration along with changes in antioxidant enzymes during regeneration in Holothuria parva was investigated for the first time. In the present study, evisceration was induced after molecular and morphological identification of the species. Most of the digestive tract and the left respiratory tree were removed from the body through the anus. The tissue regeneration of the digestive tract and changes in the activity of antioxidant enzymes [superoxide dismutase (SOD), catalase (CAT), and lipid peroxidation (LPO)] were examined during 75 days. According to the results, evisceration in this species was from the anus and the regeneration process could be divided into four steps based on the histomorphological alterations. The digestive tract grew in the form of a straight cord from the anterior end to the cloaca. During the regeneration process, several cavities were created inside the cord, which gradually joined to form a continuous lumen. For the first time on the 24th day after evisceration, food was found in the digestive tract. Fifty days after evisceration, the tissue structure of different parts derived from regenerated digest tract was found to be similar to that in the intact digestive tract. According to the results, 5 days after evisceration the activity of CAT and SOD in the regenerated digestive tract was significantly higher than in the control. The CAT and SOD levels gradually decreased in the regenerated digestive tract, although by the end of the experiment it was significantly higher than in the control group. The LPO level in eviscerated animals showed a decreasing trend during the experiment and its value decreased to the control level at the end of the experiment. [ABSTRACT FROM AUTHOR]

Background/aim: To investigate the risk factors for evisceration in a gynecological oncology population. The secondary aim was to evaluate the impact of evisceration on survival. Materials and methods: Inclusion criteria consisted of having had an elective surgery performed through a xiphoidopubic incision in our institution and having a gynecological malignancy based on pathology. A total of 198 patients were evaluated, 54 with evisceration and 144 without evisceration. Due to the widely varied prognosis of female genital cancers, the survival was analyzed on a homogenized group, including only 62 patients with primary advanced stage epithelial ovarian-tubal-peritoneal cancer. Results: The preoperative factors associated with evisceration in the univariate analysis were old age, high body mass index (BMI), hypertension, smoking, comorbidities, high American Society of Anesthesiologist (ASA) score (3 and 4), and low preoperative albumin level. The associated intraoperative factors were bleeding volume, receiving more than two units of erythrocyte suspension or fresh frozen plasma, and having had a major operation. The associated postoperative factors were the albumin transfusion and the antibiotic use in the early postoperative period. In the multivariate analysis, smoking, low levels of preoperative albumin, high BMIs, and high ASA scores (3 and 4) were independent prognostic factors for evisceration. Evisceration was not associated with recurrence and survival in the patients with primary advanced stage epithelial ovarian-tubal-peritoneal cancer. Conclusion: Smoking, preoperative hypoalbuminemia, obesity, and high ASA scores (3 and 4) were the prognostic factors for evisceration. Short-term modifiable factors such as smoking cessation and improved nutritional status should be considered in elective gynecological oncology surgeries. Evisceration had no impact on survival and recurrence in the patients with primary advanced stage epithelial ovarian-tubal-peritoneal cancer. [ABSTRACT FROM AUTHOR]

In the poultry slaughtering, accurate viscera positioning is essential to reduce the damage of internal organs. The introduction of machine vision technique can help to locate the viscera and can provide new direction for the poultry evisceration. After a midline abdominal incision of the poultry, the internal organs are taken out from the poultry that placed on the conveyor line by the parallel robot. Based on machine vision, the recognition accuracy of opened poultry viscera directly affects the level of visceral damage and residue caused by gripping manipulator. However, visceral positioning is often influenced by different noise in the abdominal cavity, such as mucous membranes and blood stains. Thus, the image segmentation of poultry viscera is a complex process, and it is challenging to remove the noise. In general, existing image segmentation methods can hardly segment visceral regions well. To strengthen the anti-noise ability, we proposed an improved region-based active contour method with the level-set formulation. This method combined with several operations of color space conversion and top-low-hat transformation, which could extract the viscera contour and precisely removed the noise. The results showed that recognition accuracy of the heart-liver area and fat area in the viscera are 98.98% and 99.75%, respectively, while the overall viscera for poultry was 98.96%. The results of this experiment suggested that the proposed image segmentation algorithm could achieve the required accuracy for poultry viscera detection. Thus, the proposed visceral contour recognition method could be applied in poultry processing, providing critical information to guide the robot for automated evisceration. [ABSTRACT FROM AUTHOR]

Sea cucumbers have been emerged as important models to study organ regeneration and development owing to the capacity to regenerate its organs quickly after evisceration. Evisceration is a special defense mechanism for sea cucumber to eject all of internal organs when they encounter predators or adverse environmental conditions. However, little was known about the dynamics of bacterial community in coelomic fluid after evisceration. In the present study, evisceration was induced by intracelomic injection of 0.35 M KCl, and the significantly alternation of bacterial community in coelomic fluid of sea cucumber Apostichopus japonicus was observed with lower diversity and total bacterial load at 7 dpe (days post evisceration) and 14 dpe. The bacterial community was tended to restore at 28 dpe. In particular, relative abundances of Bacteroidetes and Rubritaleaceae, which involved in degradation of polysaccharides and lipid, increased significantly at 7 dpe (p < 0.05), and returned to the original level at 28 dpe. In addition, the predicted functions of bacterial community indicated that the bacteria associated with metabolism pathways of amino acid, lipid and carbohydrate also increased significantly at 7 dpe. These results suggested that the bacterial community in coelomic fluid of A. japonicus was highly dynamic and could rebuild a stable community structure after evisceration. It was suggested that the enriched metabolic related beneficial bacteria at early stage played a role after evisceration in terms of decomposing polysaccharides and lipid to provide energy. [ABSTRACT FROM AUTHOR]

Automatic evisceration is a very important production technology in the chicken industry In this study, an automatic chicken eviscerating robot system was developed and evaluatec based on machine vision for locating the chicken carcasses and anal incision. This systerr consisted of chicken carcass conveying device, robotic manipulator, end-effector, contro system and machine vision system. Based on machine vision, this system employed coloi space conversion, threshold segmentation, morphological operation method and active contour algorithm to obtain the chicken carcass images of the removed wings and legs Subsequently, anal incision contour was extracted and its position was detected by ths maximum inscribed circle algorithm. All the algorithms were implemented in the systen for recognizing the individual carcass and automatically locating the targets ot differen sizes, which guided the manipulator to complete the evisceration. Present results indicatec that the maximum location deviation of contour centroid of chicken carcass and anal inci sion was 5 and 4 pixels, respectively, while the average time of image processing was 954 ms Then the eviscerating manipulator could accurately grasp the viscera, the residual rate anc the breakage rate of viscera were 6.2% and 15%, respectively. The high accuracy obtainec from the evaluation results shows that the machine vision system can be applied success fully to robotic evisceration in the processing of chicken. Hence, the development of thf method for the eviscerating robot is necessary and significant, in particular for providing great foundation for robotic evisceration in poultry industry. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the frequency of primary versus secondary eye removal, frequency of enucleation versus evisceration, and characteristics and outcomes of patients undergoing these procedures after presenting with severe ocular trauma. Patients and Methods: Retrospective chart review of patients presenting to the emergency department (ED) with severe eye trauma necessitating enucleation or evisceration between 2010 and 2018. Results: There were 92 eyes from 90 patients included in our study. Twenty-seven percent of eyes underwent primary removal (n=25, 14 enucleation, 11 evisceration), while 73% of eyes underwent secondary removal (n=67, 50 enucleation, 17 evisceration). The mean patient age was 45.2 years (range 4.2– 92.6); primary enucleation/evisceration patients were older on average than secondary eye removal patients [53.8 years (range 15.9– 91.2) versus 42.2 years (range 4.2– 91.6 years), p=0.04]. A median of 34 days passed between ED presentation and secondary enucleation/evisceration. Before undergoing secondary enucleation/evisceration, patients underwent a median of one ocular procedure (range 0– 14) for various complications of trauma including orbital infection, choroidal or retinal tear or detachment, and wound dehiscence. Open globe injury repairs comprised 43 of the 92 total procedures (47%) performed prior to secondary enucleation/evisceration. Secondary enucleations/eviscerations required a median of seven clinic visits compared to two clinic visits required after primary surgeries (p< 0.01). 10.7% of all patients (n=10) had at least one implant-related complication following enucleation/evisceration, with all but one of these patients being in the secondary enucleation/evisceration group. Conclusion: Primary enucleation or evisceration was performed in 27% of all eye removals, and enucleation was performed in 69.6% of all eye removals. Future research is warranted to determine if primary eye removal may be appropriate and when to consider enucleation versus evisceration. [ABSTRACT FROM AUTHOR]

The case report of a 86 years elderly is presented with evisceration of the small bowel through the perineum. The urgent surgical exploration of the abdomen was carried out and it was observed the perforation of the Douglas pouch and the 50 cm prominence of impacted small bowel, so that the bowel resection of the whole affected segment and end to end anastomosis was carried out. Then the Douglas pouch defect was repaired with a perineal plasty, for which a polypropylene mesh was used. This procedure is a good alternative for the surgical treatment in those who present perineal hernias, because it allows a better closing, to dissect the hernial sack and to reduce it appropriately. [ABSTRACT FROM AUTHOR]

Objective. The objective of my study was to evaluate various preoperative factors, and its prognostic significance. Currently, visual outcome for corneo-sceleral repair has improved significantly. The problem of ocular trauma is serious due to a number of factors, such as lack of adequate infrastructure, trained manpower, and lack of equipment and supplies. Unilateral blindness is a serious problem especially in pediatric age group. Material and Methods: Of the 50 consecutive patients, with Corneo-scleral lacerations and studied repaired during the period from 2016-2018, at Department of Ophthalmology Ayub Medical Institution Abbottabad. 18 %(n=9) underwent primary evisceration 82 %(n=42) were available for at least 6 months follow up. Results: The most important prognostic factors in term of good visual outcome (6/12 or better) the injury was caused by the sharp objects, laceration limited to cornea or limbus, (small size of laceration), good fundus visibility, and absence of infection. Conclusion: Even under the existing circumstances, the final visual outcome of penetrating eye injury patients with good initial visual acuity, was satisfactory. Truly, little can be done for severely shattered globes. However, visual outcome can be further improved by adopting the modern reconstructive techniques. In addition, post-operative result for refractive errors and amblyopia is essential for improving visual outcome. [ABSTRACT FROM AUTHOR]

To assess which signs and eye prosthesis care habits are related to subjective discomfort in patients with dry anophthalmic socket syndrome (DASS), using standardized tools from daily practice. 62 anophthalmic sockets were compared with their healthy fellow eye using the Standard Patient Evaluation of Eye Dryness (SPEED) score. The correlations between SPEED questionnaire and the prosthesis care, discharge characteristics score, conjunctival inflammation score, meibomian gland dysfunction (MGD) scores and Schirmer I test were studied. The anophthalmic sockets group achieved a higher SPEED test score (p < 0.01), discharge score (p < 0.01), conjunctival inflammation score (p < 0.01), MGD scores (p < 0.01) and lower Schirmer I test (p < 0.01) compared with their fellow, healthy eye. Patients with a prosthesis replacement of one year or less, those with a current fit time of one year or less and those with a cleaning frequency above one month reported better SPEED, (p < 0.01), conjunctiva inflammation (p < 0.01) and MGD scores (p < 0.01). Most anophthalmic patients suffer mild to severe DASS, which seems related to discharge, conjunctival inflammation and MGD. Moreover, certain practices related to the care of the prosthesis such as replacing with a frequency lower than yearly, current fitting time inferior to one year and a removing and cleaning regime above one month, were related to a lower discomfort sensation, conjunctival inflammation and MGD. Clinicians should consider the DASS when facing patients with anophthalmic socket and discomfort symptoms. [ABSTRACT FROM AUTHOR]

• Zone 3 injuries were the most common location of injury among all mechanisms of sports related OGIs. • Final visual outcomes did not differ significantly between penetrating-object and blunt trauma associated mechanisms of OGIs. • Most of the study cohort were adolescent males, implying the need for increased use of eye protection among this demographic. To describe the mechanisms and visual outcomes of recreational and sports-related open globe injuries (OGIs). A retrospective case series of eyes experiencing OGI secondary to recreational and sports-related activities at Memorial Hermann Hospital – Texas Medical Center (MHH-TMC) from January 1st, 2010 through March 31st, 2015 was conducted. Exclusionary criteria included no documented ophthalmologic examination upon presentation and repairs performed by services other than ophthalmology. A two-tailed t -test and Fisher's exact test were utilized to assess for statistical significance (p < 0.05). A total of 20 eyes from 20 patients experiencing OGIs secondary to recreational and sports-related activities were included. Thirteen eyes (65 %) presented with OGIs from penetrating objects while seven eyes (35 %) had injuries from blunt injuries. Males comprised most of the total study group (17 of 20 patients), and zone 3 injuries were the most common location of OGI. While eyes with OGIs from blunt trauma underwent evisceration/enucleation procedures more frequently than OGIs from penetrating mechanisms (71% vs 23 %) (p = 0.10), the final visual outcomes were similarly poor between groups. Only three eyes in this series experienced an improvement from baseline VA; all three eyes had lacked initial findings consistent with severe injury. Recreational and sports related OGIs most commonly occur in zone 3 and in young males, regardless of injury type. OGIs due to both penetrating and blunt trauma mechanisms implicate poor functional outcomes, but the absence of certain presenting injury features may indicate possibility of eventual visual recovery. [ABSTRACT FROM AUTHOR]