Case 32: Delayed-Presentation Zone I/II Open Globe Injury Requiring Corneal Glue

Abstract

A 41-year-old man presented with a delayed Zone I–II open-globe injury of the right eye from hitting his eye on a vacuum cleaner handle. CT imaging was consistent with an open-globe injury, and no intraocular lens was seen on the right on clinical exam or imaging. Due to the delayed presentation, the tissue surrounding the wound was very friable and was unable to be closed with sutures alone without a wound leak. Corneal glue was placed over the wound intraoperatively. After the cornea glue fell off a few weeks postoperatively, the wound was noted to be Seidel negative. The corneal sutures were left in place for an extended period given the complex closure requiring corneal glue. Sutures were removed under anesthesia due to patient cooperation. The final vision was 20/50 that improved with pinhole to 20/20 with an anterior chamber intraocular lens. This case emphasizes the importance of having options available intraoperatively in delayed-presentation cases as the tissue surrounding the wound may be friable and abnormal making closure difficult with sutures alone.