• Journal of Veterinary Clinics
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• v.32 no.4
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• pp.356-358
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• 2015

When severely large corneal perforation occurs, penetrating keratoplasty is a treatment of choice alternative to enucleation. A twelve-year-old male Shih Tzu was referred with perforated corneal ulcer secondary to keratoconjunctivitis sicca (KCS). Perforated cornea was directly sutured using 10-0 non-absorbable suture material, and rotational conjunctival flap was performed. However, re-perforation of cornea by wound dehiscence was observed at 1 month after operation. The yellowish lens escaped outside the orbit during corneal re-perforation, the diagnosis was re-perforated corneal ulcer, moderate corneal edema, moderate KCS (STT; 6 mm) and endophthalmitis caused by escaped lens outside orbit. Accordingly, penetrating keratoplasty (PK) and evisceration through corneal recipient site and intrascleral silicone ball prosthesis were carried out as the planned treatment, and resulted in good cosmetic improvement compared to enucliation. However, exposure of silicone ball occurred at the 9 months after the surgery due to the irritation of implant, thus enucleation was performed. In perforated large corneal ulcer with severe intraocular damage, evisceration with silicone ball insertion with PK would be alternative treatment choice to improve the cosmetic appearance.

• The Korean Journal of Nuclear Medicine
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• v.33 no.6
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• pp.484-492
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• 1999

Purpose: This study was to evaluate the clinical usefulness of $^{99m}Tc$-MDP bone scintigraphy for assessing vascular ingrowth into the ocular implants after enucleation or evisceration. Materials and Methods: Twenty-four patients (M:F=7:17, mean age: 36 years), who buried a coralline hydroxyapatite after uncomplicated enucleation or evisceration surgery were studied. Dynamic and static scintigraphy on the orbit fossa were obtained after injection of 740 MBq $^{99m}Tc$-MDP to evaluate the status of vascularization. The study was performed from the 3 to 33 weeks after surgery. According to the visual analysis, activity greater than nasal bridge was graded as 4, equal to the nasal bridge as 3, less than nasal bridge but greater than normal orbit as 2, greater than normal orbit but less than grade 2 as 1. Uptake ratio was also calculated by measuring the implants activity (H) and contralateral orbit activity (N). Grading score and uptake ratio were compared with clinical outcome of vascularization. Additionally, we also analyzed the vascularization status as time lapse between primary surgery and scintigraphic study and surgical methods. Results: Twenty-one patients who had bone scintigraphy at 11 weeks after surgery showed increased uptake above grade 2 and greater H/N ratio than 1.16. Of these, 19 patients who had drilling surgery for permanent peg application showed adequate bleeding during the procedure. The activity grade and uptake ratio were inversely correlated with vascular ingrowth. Higher than grade 2 or greater than 1.56 in H/N ratio seemed to be an indicator for better prognosis. Accomplishment of vascularization was not affected by the surgical way such as enucleation or evisceration. Conclusion: $^{99m}Tc$-MDP bone scintigraphy can be a useful method to evaluate the vascularized status of implants. Adequate time for $^{99m}Tc$-MDP bone scintigraphy may be 11-20 weeks after enucleation or evisceration.