Dr.Ekta Rishi, Dr.Geetha Iyer, Dr.Pukhraj Rishi, Dr.Bhaskar Srinivasan
Chemical injury causes severe contraction of lids, adnexa and anterior segment. Perforations lead to retinal and choroidal detachment with reduced axial length. General anethesia is a challenge due to contractures. Patient requires a large lamellar corneoscleral graft before a temporary keratoprosthesis is fixed. Retina is pulled anteriorly in the pupillary region and sclerotomies go through retina. The anterior adhesions of retina require a 360 degree retinectomy and removal of pre and subretinal membranes. Retina is settled with LPFC and then laser and LPFC oil exchange is done. The video discusses the difficulties faced in these surgeries, multiple surgeries required like settling retina, mucous membrane grafting for dry eyes, stages of Osteo-odonto keratoprosthesis. It emphasizes teamwork between retina and ocular surface surgeon and also emphasizes that the contraction of globe is mainly anterior and the surgery is performed in 13.9 mm axial length.
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