![]() Non-iatrogenic traumatic causes involve sharp injuries, intraocular foreign bodies, or blunt injuries causing increased intraocular pressure and inside out injury leading to open globe injury (rupture). Occasionally, complete sloughing of strangulated tissue within the suture loop may occur. Once communication between the posterior wound gap and the anterior wound defect occurs (subsequent to tissue necrosis from tight sutures), anterior aqueous fluid may egress vitreous incarceration may also occur, producing the vitreous wick. Tightly compressed corneal wound edges may demonstrate puckering and also may lead to enlargement of suture tracts, promoting tissue necrosis within the suture loop. Poor suturing technique is implicated as a major factor for wound breakdown. Ĭorneal wound healing has been documented to be slower on the endothelial side (inner layers). Microscopic wound breakdown has been hypothesized as the “point of no return” for the development of vitreous wick syndrome-a point emphasized by Ruiz and Teeters in their initial description. ![]() Vitreous wick syndrome of iatrogenic origin usually follows anterior-segment surgery, though it may also follow sub Tenon injection and muscle surgery if sclera is perforated. Vitreous wick syndrome develops in the setting of trauma, either iatrogenic or non-iatrogenic. ![]() No gender predisposition has been identified, and the condition has no apparent racial predilection. No age predisposition has been documented for this syndrome. Inadequate prolapsed vitreous removal during repair of scleral or sclerocorneal lacerations or scleral meltsīoth in the United States and throughout the world, vitreous wick syndrome is rare.Sutureless small-gauge pars plana vitrectomy.Transconjunctival/transscleral intravitreal injection of pharmacologic agents.Complicated cataract surgery with posterior capsular rupture and inadequate anterior vitrectomy with adhesion to the surgical wound.Routine cataract surgery with unrecognized posterior capsular rupture or zonular dehiscence with vitreous prolapse and adhesion to the surgical wound.Vitreous wick syndrome may result from the following situations: With the rise of intravitreal drug delivery devices currently available, vitreous wick syndrome may become more common. Vitreous wick syndrome has also been identified as a potential cause of endophthalmitis after intravitreal injection of triamcinolone through the pars plana. Subsequently, however, posterior fistulous tracts with vitreous entrapment were reported after vitreoretinal surgery. Vitreous wick syndrome occurs after eye surgery or trauma and is characterized by microscopic wound breakdown accompanied by vitreous prolapse that develops into a vitreous 'wick'.Īt first, vitreous wick syndrome was limited to anterior-segment procedures. Vitreous wick syndrome, "vitreous tug syndrome" as reported by Iliff, or vitreous touch syndrome, is characterized by vitreous bands or strands to the corneal wound which can be associated with cystoid macular edema (Irvine-Gass Syndrome).
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