Images in Paediatrics
Corneal perforation. A rare complication of birth trauma
Perforación de la córnea: una complicación poco común del traumatismo del nacimiento
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A rare complication of birth trauma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e1" "paginaFinal" => "e2" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Tiago Magalhães, André Assunção, Renato Silva, Filipa Flor-de-Lima, Henrique Soares" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Tiago" "apellidos" => "Magalhães" "email" => array:1 [ 0 => "tiagoaugmagalhaes@hotmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "André" "apellidos" => "Assunção" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Renato" "apellidos" => "Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Filipa" "apellidos" => "Flor-de-Lima" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "Henrique" "apellidos" => "Soares" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Unidad de Cuidados Intensivos Neonatales, Servicio de Neonatología, Centro Hospitalar Universitário de São João, Oporto, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Facultad de Medicina, Universidade do Porto, Oporto, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Oftalmología Pediátrica, Centro Hospitalar Universitário do Porto, Oporto, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Perforación de la córnea: una complicación poco común del traumatismo del nacimiento" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 621 "Ancho" => 1255 "Tamanyo" => 60127 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0100" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The irregular borders of the right eye associated with the sunken appearance of the globe support the diagnosis of eye perforation. Imaging findings suggestive of crystalline lens rupture and choroidal detachment.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A woman aged 31 years was admitted to the emergency department in active labour after an uncomplicated pregnancy. After forceps and vacuum extraction attempts failed, she underwent an emergency caesarean section.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The Apgar score was 3 at 1<span class="elsevierStyleHsp" style=""></span>min, 8 at 5<span class="elsevierStyleHsp" style=""></span>min and 9 at 10<span class="elsevierStyleHsp" style=""></span>min. The physical examination of the newborn was normal, save for bruises in the face and a lesion in the eye (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). At 4<span class="elsevierStyleHsp" style=""></span>h post birth, the infant was admitted to the neonatal intensive care unit, where examination by an ophthalmologist confirmed perforation of the right cornea associated with iris prolapse and hyphaema. A head CT scan evinced the presence of ocular perforation, a dysmorphic crystalline lens and choroidal detachment (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The infant underwent suturing of the corneal perforation at 7<span class="elsevierStyleHsp" style=""></span>h post birth, without intraoperative complications (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A). The postoperative ultrasound scan of the eye found evidence of vitreous haemorrhage. Treatment was initiated with intravenous dexamethasone, topical tropicamide, ofloxacin, chloramphenicol and prednisolone. At three weeks, the cornea appeared clearer, the vitreous haemorrhage was reabsorbing and the lens was located in the anterior chamber of the eye. At 2 months, the patient underwent a lensectomy-vitrectomy to resolve the complications of the crystalline lens rupture (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Obstetric trauma in instrumental deliveries can give rise to a wide range of lesions. Most ocular lesions are minor.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Corneal perforation secondary to obstetric trauma is infrequent and has only been reported in isolated cases.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Corneal perforation usually requires surgical intervention and its outcomes depend on the development of postoperative complications.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> To our knowledge, this is one of the few published cases of corneal perforation secondary to obstetric trauma.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-08-20" "fechaAceptado" => "2021-09-03" "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 501 "Ancho" => 1255 "Tamanyo" => 86639 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0095" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Perforation of the right cornea with iris prolapse. Facial bruising.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 621 "Ancho" => 1255 "Tamanyo" => 60127 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0100" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The irregular borders of the right eye associated with the sunken appearance of the globe support the diagnosis of eye perforation. Imaging findings suggestive of crystalline lens rupture and choroidal detachment.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 592 "Ancho" => 1255 "Tamanyo" => 116889 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0105" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Appearance of the cornea of the right eye after surgery. Visible hyphaema despite the presence of diffuse corneal oedema. The arrow points at the location of the suture in the cornea. (B) After the removal of the lens: increased transparency of the cornea, residual fibrosis secondary to trauma (white arrow) and air bubble in the anterior chamber of the eye at the end of surgery (black arrow).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Forceps delivery-related ophthalmic injuries: a case series" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. McAnena" 1 => "M. O’Keefe" 2 => "C. Kirwan" 3 => "J. Murphy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3928/01913913-20151014-50" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Ophthalmol Strabismus" "fecha" => "2015" "volumen" => "52" "paginaInicial" => "355" "paginaFinal" => "359" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26584749" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Globe rupture in a neonate following forceps delivery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.P. Théra" 1 => "B. Théra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.19070/2332-290x-1600057" "Revista" => array:4 [ "tituloSerie" => "Int J Ophthalmol Eye Sci" "fecha" => "2016" "paginaInicial" => "270" "paginaFinal" => "271" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of corneal perforation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "V. Jhanji" 1 => "A.L. Young" 2 => "J.S. Mehta" 3 => "N. Sharma" 4 => "T. Agarwal" 5 => "R.B. Vajpayee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.survophthal.2011.06.003" "Revista" => array:6 [ "tituloSerie" => "Surv. Ophthalmol" "fecha" => "2011" "volumen" => "56" "paginaInicial" => "522" "paginaFinal" => "538" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22117886" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000010000000005/v1_202405192134/S2341287924000668/v1_202405192134/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000010000000005/v1_202405192134/S2341287924000668/v1_202405192134/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287924000668?idApp=UINPBA00005H" ]
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