Previous Eye Surgery Repair: Expert Solutions For Improved Vision
Any type of surgery carries some degree of risk and in spite of our best efforts, complications can and do happen! In such cases, patients can often benefit from revision surgery to correct problems that arose during their 1st procedure and Dr. Singh commonly gets referrals of such complex surgical cases from community ophthalmologists in the DC/NOVA/MD area.
Dr. Singh specializes in difficult revision surgeries; reconstructing damaged ocular tissues, and restoring vision to patients. Sometimes the surgery in question might be a lens exchange if an incorrect lens power or model was placed or recentratio of a dislocated lens. Prolene sutures can be used to repair a damaged iris, and restore roundness to a compromised pupil.
These same procedures can also be used to help restore or at the very least improve vision in patients who sustain trauma to the eye in car accidents, bungee cord impacts, hand to hand combat, or blast injuries (often seen in military personnel). In cases like these, victims undergo a staged reconstructive approach starting with an initial emergency repair of the eye to close any leakage and then months later a more complicated revision procedure to restore normal structure and function to the eye. Dr Singh has expertise in these cases and many ophthalmologists in Virginia and beyond refer such cases to Singh Vision for reconstruction. Some examples of gnarly cases that walked through the door over the years are shown below.
A traumatic globe rupture with penetrating injury and scleral tissue loss that required emergent placement of irradiated scleral tissue to close the leaking eye.
1 month later the patient was seeing 20/40 and correcting to 20/20! Remarkable considering the presenting injury of a roof shingle shard in the eye!
A horrific corneal fungal infection presenting in clinical with total corneal melt.
Post Operative Day 1, patient was starting to look better.
A globe rupture with severe iris prolapse and traumatic iris loss. See next picture.
Note the area of corneal laceration (presenting trauma) that was repaired inferiorly. 14 months after globe rupture, an iris repair was done to the extent possible (not yellow lines indicate location of 4 throw pupilloplasty sutures. Inferiorly iris thinning persists. Making the best of a bad situation! The patients vision ultimately improved from 20/400 to 20/60. With correction, got to 20/40!
A case of Aqueous misdirection with resultant iris trauma in need of repair.
A poorly positioned ACIOL causing corneal decompensation.
Rapidly clearing cornea after ACIOL explantation, glued IOL placement, and DMEK corneal transplantation. Persistent inferior corneal edema is noted in a region of graft detachment.
After AC rebubbling the cornea clears dramatically with I and II dots on DMEK grafted noted in picture.
See dot placement indicating an attached DMEK graft.
Traumatic dislocation of a previously placed 3 Piece intraocular lens in a patient with Marfan’s Disorder.
Partial traumatic iridodialysis with traumatic tissue loss of central cornea causing severely compromised central vision and debilitating peripheral glare.
After staged surgical repair including iridodialysis repair and penetrating keratoplasty, pt had 20/40 uncorrected vision at Post Operative Month 3 and 20/20 vision with contact lenses.
An infected Ahmed Glaucoma Valve leaking purulent infection material into the eye!
Horrifically failed Penetrating Keratoplasty with total opacification of the cornea and no view to the anterior segment of the eye.
Post Op Day 1 after repeat PK with fine needle diathermy to ablated sentinel vessels, a beautifully intact anterior segment is seen.
Another case showing post operative results with placement of glue amniotic membrane seen in area of previous pterygium location.