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Objectives: To assess the overall mental health of enucleated or eviscerated patients after high-density porous polyethylene OCULFIT implantation and external prosthesis over a 1-year follow-up. Methods: Patients with an indication of enucleation or evisceration with OCULFIT implantation were included in a prospective study. The patients completed four questionnaires regarding mental health at three different visits (baseline, 3–6 months, and 9–12 months post-surgery). The questionnaires used were the following: SF-12 for multidimensional health-related quality of life (scale 0–100); Rosemberg self-esteem scale (scale 0–40); Patients Health Questionnaire-4 (PHQ-4) (scale 0–6); and a Lifetime Major Depression and Anhedonia questionnaire (categorised in groups with/without symptoms). Results: A total of 33 patients (16 enucleations and 17 eviscerations) were included in the study. The physical domain of the SF-12 questionnaire did not change between visits, but the mental domain significantly improved from the baseline to the last visit (41.71 ± 12.72 vs. 46.80 ± 10.68, p = 0.04). The number of patients with high, moderate, and low self-esteem (Rosemberg scale) was similar between the baseline and the last visit. The depression and anxiety scores of the PHQ-4 were not significantly different among visits. The number of patients with no symptoms (depression or anhedonia) improved from the baseline (42.2%) throughout the follow-up (66.7% at the last visit). Conclusions: OCULFIT orbital implant and external prosthesis placement maintained and/or improved the quality of life related to mental health in eviscerated and enucleated eyes. The number of patients with no symptoms improved from the baseline throughout the follow-up. The patients' self-esteem was already high before implantation and remained stable over the follow-up. [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

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.

Objectives: To assess the overall mental health of enucleated or eviscerated patients after high-density porous polyethylene OCULFIT implantation and external prosthesis over a 1-year follow-up. Methods: Patients with an indication of enucleation or evisceration with OCULFIT implantation were included in a prospective study. The patients completed four questionnaires regarding mental health at three different visits (baseline, 3–6 months, and 9–12 months post-surgery). The questionnaires used were the following: SF-12 for multidimensional health-related quality of life (scale 0–100); Rosemberg self-esteem scale (scale 0–40); Patients Health Questionnaire-4 (PHQ-4) (scale 0–6); and a Lifetime Major Depression and Anhedonia questionnaire (categorised in groups with/without symptoms). Results: A total of 33 patients (16 enucleations and 17 eviscerations) were included in the study. The physical domain of the SF-12 questionnaire did not change between visits, but the mental domain significantly improved from the baseline to the last visit (41.71 ± 12.72 vs. 46.80 ± 10.68, p = 0.04). The number of patients with high, moderate, and low self-esteem (Rosemberg scale) was similar between the baseline and the last visit. The depression and anxiety scores of the PHQ-4 were not significantly different among visits. The number of patients with no symptoms (depression or anhedonia) improved from the baseline (42.2%) throughout the follow-up (66.7% at the last visit). Conclusions: OCULFIT orbital implant and external prosthesis placement maintained and/or improved the quality of life related to mental health in eviscerated and enucleated eyes. The number of patients with no symptoms improved from the baseline throughout the follow-up. The patients’ self-esteem was already high before implantation and remained stable over the follow-up.

Objectives: The study aimed to evaluate the demographic and clinical characteristics of evisceration cases and to assess the psychosocial effects of prosthesis usage using the newly defined Global Ocular Prosthesis Score (GOPS). Methods: The records of 245 patients who underwent evisceration surgery between January 2010 and May 2021 were retrospectively reviewed. The study included 216 eyes of 216 patients who had regular follow-up of at least 6 months. Their demographic characteristics, indications for surgery, surgical methods, implant size, and complications were recorded. A total of 175 patients with ocular prostheses were evaluated using a 20-item questionnaire called GOPS. Results: About 154 of the 216 patients were male (71.3%), and 62 were female (28.7%), with a mean age of 34.9 years (range: 3-83). The mean follow-up duration was 52.5±34.2 months (range: 6-125). Among the cases, 101 (46.7%) had a penetrating globe injury, 91 (42.1%) had painful absolute eyes, 10 (4.6%) had corneal abscess, 8 (3.7%) had painless blind eyes due to Behçet's disease, 7 (3.2%) had endophthalmitis, 1 (0.04%) had prematurity retinopathy, 1 (0.04%) had corneal melting due to toxic epidermal necrolysis, and phthisis bulbi. Most of the traumas (74.5%) were caused by young (mean age 33.6 years) males. Sphere extrusion was observed in 16 (7.4%) patients at an average of 3 months (15 days to 6 months). Tenon cyst excision was performed in two patients. The mean GOPS was 71.74. Conclusion: It has been observed that the most common reasons for evisceration in a tertiary eye hospital are globe injuries and painful eyes. Although losing an eye can have negative physical and psychological effects on patients and may prevent them from fulfilling their social roles, it has been observed that the use of ocular prostheses positively impacts patient satisfaction. The use of the GOPS questionnaire can be helpful in assessing the quality of life of evisceration patients. [ABSTRACT FROM AUTHOR]

Abstract 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.

Purpose: to evaluate the long-term results of using polytetrafluoroethylene orbital implants in patients with anophthalmos.Patients and methods. The clinical group consisted of 1560 patients with blind and unpromising eyes or anophthalmos, who were divided into 3 groups (I, II, and III) depending on the method of surgical treatment used — evisceration of the eye with posterior pole resection and neurectomy, enucleation of the eye, and plastic orbital socket surgery, respectively.Results. All patients in the study groups showed a positive result according to the criteria: stump mobility averaged (130,1°), prosthesis mobility averaged (106,6°), prosthesis entrapment after evisceration was less common than in patients after eye enucleation by 14.5 %. And the average value of the prosthesis sinking (mm) was lower by 78.0 %. Occlusion of the upper eyelid was also 16.7 % less common, and the average occlusion of the upper eyelid (mm) was 37.3 % lower. PTFE orbital implants have proven to be affordable, biocompatible and easy to use implants. The effect of the operation remained stable with long-term follow-up up to 15 years. There were no complications directly related to the use of PTFE orbital implants.

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]

Objectives: The objective of this study was to compare anxiety, depression, self-esteem, and quality of life in patients who underwent surgical removal of an eye with those of controls as well as to test the correlations of these variables in both groups. Methods: Beck anxiety inventory (BAI), Beck depression inventory (BDI), 36-item short-form health survey (SF-36), and Rosenberg self-esteem scale were administered to 29 patients with surgical removal of an eye and 30 control subjects. Results: The patient group had significantly lower scores on physical functioning, role limitations due to physical and emotional problems, pain, and general health perception domains of SF-36, as well as significantly higher BDI (p=0.004) scores as compared to controls. The study groups did not differ significantly with respect to BAI scores and energy/vitality, mental health, and social functioning domain scores of SF-36 (p>0.05). Conclusion: This population of monocular patients had similar mental health-related and Beck’s Anxiety Inventory scores equivalent to the control group despite the surgical removal of one eye. However, lower scores for some SF-36 domains and higher depression levels in this patient group suggest that psychiatric rehabilitation should be considered after eye removal to improve the psychological outcomes and quality of life in these patients. [ABSTRACT FROM AUTHOR]

Uterine perforation is a major but rare complication of surgical abortion, with some of the dreaded complications being 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, and a history of surgical abortion may not being forthcoming at most of the time. A high index of suspicion should be kept while imaging the patient in an emergency setting, since early diagnosis is key to survival, especially if an unsafe abortion has been performed. 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.

Many species of sea cucumbers (Echinodermata, Holothuroidea) perform evisceration, i.e., ejection of internal organs including digestive tracts when responding to environmental stresses. After evisceration, they also show a high regenerative capacity, in which all the eviscerated organs regenerate. Especially in anterior evisceration species, the oral complex structure consisting of multiple organs, including the digestive tract and central nervous system, are reconstructed. The detailed developmental mechanisms underlying the process remains unclear, and therefore, in this study, focusing on Eupentacta quinquesemita, gene expression analyses in the regenerating tissues were carried out. For the formation of the gut tube, genes involved in mesenchymal-epithelial transition were upregulated consistently with the histological changes. Upregulation of Hox and Parahox genes along the anterior-posterior axis was observed, implying the involvement of these genes in the spatial differentiation of the digestive tract. In addition, the expression of otx, six and pax, i.e., transcription factors patterning anterior nervous tissues, was upregulated during the regeneration of the central nervous system. Taken together, these results suggest that conserved genes are co-opted to the internal organ regeneration after evisceration in sea cucumbers. [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]

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]

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]

Mucormycosis is an invasive fungal infection that can cause acute clinical decompensation and death. The literature demonstrates case fatality rates around 50% with differential clinical courses contingent upon anatomical incursion. Rhino-orbital cerebral mucormycosis represents a rapidly hostile variant with poorer outcomes, warranting prompt recognition, workup, and intervention. It is seldom included in differential diagnoses in those with head and neck pathology within the inpatient setting as diagnostic parsimony and low prevalence lead this entity to be often overlooked. Given the acuity and risk factors involved, considering mucormycosis may be prudent during the assessment of hyperglycemic or immunodeficient patients exhibiting maxillofacial disease. When acquiring histories of presenting illness and performing physical examinations, assessment includes mindfulness of diabetes mellitus, craniofacial lesions, and alertness to clinical deterioration. Given the rising incidence of complicated diabetes mellitus in conjunction with a paucity of mucormycosis reports noting the orbit as the diagnostic harbinger, we report the case of a 59-year-old woman admitted to the critical care setting for diabetic ketoacidosis and altered mental status. Physical examination revealed a swollen orbit, later diagnosed as mucormycosis with associated sino-orbit involvement and cranial nerve deficits warranting urgent and extensive facial debridement. [ABSTRACT FROM AUTHOR]

Case summary A 2-year-old domestic shorthair queen sustained a tear in the vaginal wall through which the queen herniated a fetus during parturition. An exploratory laparotomy was performed, the patient had an ovariohysterectomy and the fetus was removed vaginally. The tear was managed medically with antibiotics, analgesics and careful monitoring. Assessment of the injury site 2 weeks later confirmed successful healing without the need for surgical intervention in the vaginal wall. Relevance and novel information This is the first report in veterinary medicine describing the successful medical management of a dystocia-related vaginal wall tear in a feline patient without surgical repair. [ABSTRACT FROM AUTHOR]

Abstract 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.

The eyes, being one of the most prominent facial features, play a crucial role in facial symmetry and are subject to extensive scrutiny in terms of their morphological and functional aspects. Numerous studies have explored the association between facial symmetry and the morphology of the eyes. Symmetrical faces are generally perceived as more attractive and are believed to indicate good genetic health. As a result, research has focused on the measurements of ocular symmetry, including inter-eye distance, eye shape, and eyelid symmetry. It has been found that individuals with more symmetrical eyes are often perceived as more attractive and exhibit enhanced social desirability. The eyes play a crucial role in facial expression and are vital sensory organs. A 49-year-old patient presented with a chief complaint of facial disfigurement due to shrunken right eyelids resulting from trauma-related evisceration. Various techniques for iris positioning have been reported in the literature, but they have had limitations. This clinical report presents an improved and effective technique utilizing a customized iris positioning device, consisting of a transparent graph sheet attached to a forehead clip. The customized ocular prosthesis significantly improved the patient's quality of life and restored her self-confidence. The customized iris positioning device offered enhanced proximity to the eye and provided several advantages, including accurate pupil centralization, customization, re-verification, and being cost-effective. [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]

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]

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]

Aim: To analyze the clinical outcome of first 100 consecutive cases of therapeutic penetrating keratoplasty (TPK) done at a tertiary eye care centre in Eastern India. Materials and Methods: A retrospective analytical observational study of first 100 consecutive patients of TPK was done at RIO, IGIMS, Patna, Bihar for nonhealing keratitis with or without perforation with a minimum 1 year follow up examination. Patients with vitreous exudates were excluded from the study. Results: Organisms were isolated in 60% of cases of which 65% were fungi (Aspergillus), 20% were bacteria, (Staphylococcus aureus) and 15% had mixed infection. 17 cases required lens removal during surgery. Repeat graft infection was noticed in 23 cases of which 9 had fungi, 2 had bacterial isolate and rest was inconclusive preoperatively. A repeat TPK was performed in 7 patients out of the reinfected cases. Anatomical restoration could be achieved in 96% of cases. Graft clarity allowing clear view of anterior chamber could be seen in 26 cases. 4 cases of graft infection with posterior segment involvement finally required evisceration. 47 out of 100 TPK cases had raised intraocular pressure (IOP) of which 10 underwent glaucoma surgery for uncontrolled IOP despite medications. Conclusion: TPK is a challenging surgery still having definite role in management of nonresponding progressive keratitis. Maintaining graft clarity postoperatively is a difficult task in these cases therefore success should be measured in terms of infection eradication and anatomical restoration.

Coronavirus infection most commonly presents with mild influenza-like symptoms. The most common ocular presentation is conjunctivitis. We report four patients of COVID-19 infection presenting as orbital cellulitis. They all were incidentally found COVID-19 positive on reverse transcription polymerase chain reaction. All had painful edema of eyelids, extraocular movement restriction, and other symptoms of orbital cellulitis at presentation. Three of 4 had uncontrolled diabetes and one had coronary artery disease. Proven mucormycosis was present in two patients; cerebral involvement (abscess and stroke in 1 each) in two patients. Two of them died, one underwent orbital exenteration and one developed hemiplegia due to stroke. COVID can present as orbital cellulitis and carries a very grave prognosis.

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.

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]

BackgroundEnterocele is an uncommon, serious condition that requires accurate and early diagnosis to prevent complications such as intestinal obstruction, incarceration, and strangulation, with consequent intestinal ischemia, necrosis, and evisceration. We report a rare case of a patient with a voluminous enterocele and initial signs of intestinal ischemia who underwent urgent vaginal surgery.Case descriptionAn 80-year-old woman presented with a voluminous mass protruding from the vagina, associated abdominopelvic pain, a 10-day history of bowel sub-occlusion, and numerous episodes of profuse vaginal bleeding. She was diagnosed with an enterocele with early signs of complications. Owing to her advanced clinical condition and comorbidities, we opted for an urgent vaginal procedure. Intestinal loops with initial signs of ischemia were resected via a transvaginal approach, leading to good clinical outcomes. She was discharged on postoperative day 5.ConclusionsThis rare case highlights a surgical emergency that was managed with transvaginal resection of the intestine. Early identification of the initial signs of complications allowed for this less invasive approach, resulting in reduced morbidity and length of hospital stay.

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.

The patient, who had no social security and had keratitis in his eye, presented with corneal melting 2 weeks later. Evisceration was recommended to the patient whose light sensation was positive. With keratoplasty and lid surgery, the eye was kept in place and the vision increased to the level of hand movement.

The eyes, being one of the most prominent facial features, play a crucial role in facial symmetry and are subject to extensive scrutiny in terms of their morphological and functional aspects. Numerous studies have explored the association between facial symmetry and the morphology of the eyes. Symmetrical faces are generally perceived as more attractive and are believed to indicate good genetic health. As a result, research has focused on the measurements of ocular symmetry, including inter-eye distance, eye shape, and eyelid symmetry. It has been found that individuals with more symmetrical eyes are often perceived as more attractive and exhibit enhanced social desirability. The eyes play a crucial role in facial expression and are vital sensory organs. A 49-year-old patient presented with a chief complaint of facial disfigurement due to shrunken right eyelids resulting from trauma-related evisceration. Various techniques for iris positioning have been reported in the literature, but they have had limitations. This clinical report presents an improved and effective technique utilizing a customized iris positioning device, consisting of a transparent graph sheet attached to a forehead clip. The customized ocular prosthesis significantly improved the patient’s quality of life and restored her self-confidence. The customized iris positioning device offered enhanced proximity to the eye and provided several advantages, including accurate pupil centralization, customization, re-verification, and being cost-effective.

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.

Transanal evisceration of the small bowel is a rare surgical emergency. Rectal perforation in such cases is usually due to an underlying rectal prolapse. We report a case of a middle aged (45 years) male with spontaneous rectal perforation and transanal evisceration of the small bowel. Approximately 150 cm of small bowel had eviscerated transanally and the patient required emergent abdominal exploration, reposition of the small bowel, and repair of the rectal perforation. Small bowel evisceration through the anal verge is an emergent condition and the aim was to prevent life threatening complications related to sepsis.

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]

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., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)

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]

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]

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.

Purpose: to study the subpopulation composition of peripheral blood lymphocytes in patients with long — term chronic post-traumatic uveitis (CPT).Patients and Methods. There were 131 people aged 17 to 87 years, who received the surgical treatment in the Department of plastic surgery and eye prosthetics in NMITS eye diseases Helmholtz of the Ministry of health, Russia, where the removal of the eyeball by evisceration was carried out in 101 patients (70.3 %), 30 patients (29.7 % of cases) were enucleated. The study identified two groups: the Ist group– with the outcome of the injury, including non-penetrating (n = 46) and penetrating wounds (n = 51) of the eyes, were 97 patients; group II included 34 patients with complications due to single (n = 8) or repeated (n = 26) ophthalmic surgery (development of glaucoma and retinal detachment).Results. When analyzing the mean values, we found a decrease in the relative number of CD3+ CD4+ helpers/inducers in the blood of patients of both groups (up to 43.5 ± 0.81 and 42.19 ± 1.29 % versus 45.7 ± 1.19 % in the control), statistically confirmed for the 2nd group. Individual analysis revealed multidirectional shifts from the norm of cellular immune status of patients with PU in both groups. The most interesting, in our opinion, results were obtained by analyzing the relative number of effector cytotoxic cells of adaptive and nonspecific immunity. The increase in the relative content of t-cytotoxic lymphocytes CD3+ /CD8+ and NK-lymphocytes CD16+ /CD56+ was revealed with the same frequency, approximately in 18.5 and 19.5 % of cases in the PU group at the outcome of injury, in the 2nd group the increased number of these subpopulations was observed more often, amounting to 23.5 and 20.5 %, respectively.Conclusions. The results of the study on a large clinical material indicate that in long-term CPTU there is a pronounced systemic imbalance in the immunoregulatory subpopulations of lymphocytes, revealed by individual analysis in groups of patients.

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]

Suppapong Tirakunwichcha,1 Pear Pongsachareonnont2 1Ophthalmic Plastic and Reconstructive Surgery Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand; 2Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandCorrespondence: Suppapong Tirakunwichcha Email suppapong@gmail.comPurpose: 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.Keywords: evisceration, traumatic open-globe injury, residency training, ruptured globe

Background: Gonococcal ocular lesions develop most commonly due to poor hygiene habits, when the infection is transmitted by eye-hand contact; in addition, they may develop when the infection is transported to the eye as a result of hematogenous or lymphogenous spread. Purpose: To present a rare case of endophthalmitis secondary to gonococcal sepsis, and to highlight its clinical features. Material and Methods: Visual acuity assessment, comprehensive eye examination, and microbiological examination. Results: Patient’s history was significant for acute suppurative gonococcal prostatitis (with acute retention of urine, and severe sepsis with liver abscess, and suppurative tonsillitis), for which he had been treated as an in-patient at the Department of Urology of the city hospital. In addition, he had suppurative blepharitis of the left eye. A week after he was discharged from the Department of Urology, he was hospitalized to the Department of Ocular Trauma of the Filatov institute with the diagnosis of endophthalmitis in the left eye. The patient poorly responded to treatment, and clinical manifestations of endophthalmitis were becoming more and more severe. He underwent evisceration of the left eye. Conclusion: Consultations of allied health professionals and multiprofessional management of gonorrhea patients are required to prevent complications in various organs and systems, should gonococcal sepsis develop.

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.

PurposeTo analyze the clinical characteristics of trauma-dominant orbital cellulitis (OC) and evaluate the risk factors associated with evisceration.MethodsThis retrospective study included inpatients diagnosed with orbital cellulitis at the Zhongshan Ophthalmic Center between January 2010 and December 2020. The demographic features, etiology, clinical characteristics, microbiological isolates, and risk factors associated with evisceration were analyzed.ResultsAmong 148 consecutive subjects (n = 148, 148 eyes), the mean age was 42.07 ± 20.35 years and 70.27% were male. Penetrating globe injuries were the most common (52.03%). No light perception (NLP) was recorded in 50% of patients on admission. Endophthalmitis was observed in 103 cases (69.59%), intraocular foreign bodies (IOFB) were detected in 43 cases (29.05%), and total corneal melting was observed in 31 cases (20.95%). Sixty patients (40.54%) underwent evisceration. Logistic regression analysis showed that total corneal dissolution [odds ratio (OR) = 83.019, P = 0.000], IOFB (OR = 3.402, P = 0.016), and NLP (OR = 0.185, P = 0.001) were risk factors for evisceration. Microorganism detection showed that Pseudomonas aeruginosa and Bacillus cereus were the leading pathogens.ConclusionAmong hospitalized trauma-dominant OC patients, middle-aged men were the major subjects and penetrating globe injury was the major cause. Significant complications such as complete visual loss and evisceration were unavoidable in many patients with OC in the current study. NLP, IOFB, and total corneal melting were the risk factors for evisceration.

Angela C Gauthier, Oluseye K Oduyale, Michael J Fliotsos, Sidra Zafar, Nicholas R Mahoney, Divya Srikumaran, Fasika A Woreta Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USACorrespondence: Fasika A WoretaWilmer Eye Institute, Johns Hopkins School of Medicine 600 North Wolfe Street, Baltimore, MD 21205, USATel +1 410-961-2868Fax +1 410-614-9632Email fworeta1@jhmi.eduPurpose: 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.Keywords: evisceration, enucleation, open globe repair, traumatic eye injury

Abstract Conventional automated slaughter lines for pigs are organised as disassembly lines with many specialised machines. High costs and capacities make them relevant only for large scale meat production. The ambition with the novel Meat Factory Cell (MFC) concept is to provide the meat industry with a robust and flexible automation platform that is also relevant for smaller scale production. The MFC process deviates radically from conventional processing of pig carcasses after singeing. In MFC, the limbs are removed first. Then the dorsal muscles along the spinal axis from tail to head are removed with the column and rind in one meat cut, followed by removal of the viscera. Finally, the cut ribs and belly are removed. Such approaches to automation in pig abattoirs and cutting plants are highly needed in smaller scale production, and they should produce meat and offal as hygienically as conventional factories. This case study reports the evisceration of 37 pigs in 9 trials performed in 2019. Several approaches were tested with a prototype carcass holding unit. Evisceration could be undertaken without the need to cut through the gastrointestinal tract from tongue to rectum, reducing the probability of accidental faecal contamination of pork carcasses from the gut content. The Meat Factory Cell procedure is an advance towards automated evisceration of pig carcasses which is both simple and hygienic. The traditional separation of internal organs into a pluck set and a set of stomach and bowels was more prone to leakages.

AIM: To investigate the risk factors for eye removal following ocular trauma at a major ophthalmology department in China. METHODS: A retrospective study of patients who underwent eye removal surgery following ocular trauma was completed. Clinical outcomes were consulted in detail through the hospital’s computed medical data system. Patients’ information including age, gender, cause of ocular trauma, affected eye, and education level was collected and recorded in a standardized database. Chi-squared test, Student’s t-test, Fisher’s exact test, and bivariate correlation analysis were used for statistical comparisons. RESULTS: The present study included 1675 removal eyes from 1674 patients over the 20-year period. Patients included 80.5% males and 19.5% females, with mean age of 38y. The majority of the patients (70.7%) were blue-collar workers (physical laborers), and 1098 patients (65.6%) did not receive high school education. Work-related injuries were the most common reason for eye removal (n=739, 44.1%), of which 441 cases (59.7%) were related to metal/nail wounds. The most frequent injury type in males was work-related injuries (49.7%), whereas the most frequent injury type in females was home-related injuries (25.8%). CONCLUSION: Work-related injuries are a leading cause of severe ocular injury resulting in eye removal. In addition, men and undereducated patients are more likely to undergo eye removal surgery following ocular trauma. This study identified multiple high-risk factors leading to eye removal following ocular trauma, which is of great importance for preventing severe eye injuries.