案例討論
Case 1  (2023/01/20 小年夜)   Age:  68 y/o Gender: Male  Mechanism:  工作時鐵釘刺傷右眼，兩天後就診。
VA:  HM OD  IOP:  N/A
Cornea: 5mm laceration wound, Seidel test (-) OD
A-C: deep/cell++++ OD ;Lens：traumatic cataract
Vitreous and Fundus: not visible
Orbital CT: no obvious IOFB, nor hemorrhage
OP finding: vertical cornea laceration 5 mm,traumatic cataract with ant. capsule       rupture(suspected zonule weakness)
Surgical intervention :1.Lens ECCE ,2.Cornea Wound repair ,3.Vitreous Intravitreous          abx injection
POD1   IOP: 4/13mm Hg OD/OS
AC: deep/blurry, seems residual capsule OD ;Lens: aphakia OD
Fundus: invisible due to cornea edema OD
Post-op 1week
VA: HM OD IOP: 7/15mm Hg OD/OS
AC: deep/seem residual capsule or cortex OD;Lens: aphakia OD
Vitreous and Fundus: not clearly visible OD (B scan: no RD)  
Case 2  (2023/01/27 初六)  Age:  45 y/o Gender: Male   Mechanism:  鐵絲刺傷右眼，隔天就診。
VA:  0.4 OD IOP: 21/15 mmHg OD/OS
Finding (OD)
Cornea: small laceration wound over 5 o'c, Seidel (-) 
A-C: deep/silent ;Lens: traumatic cataract 
Vitreous and Fundus: Pinkish disc and attached retina 
Cornea: small laceration wound over 5 o'c , Seidel (-) 
Orbital CT: no obvious IOFB, nor hemorrhage
OP finding :one paracentral cornea wound without leaking,traumatic cataract with ant. capsule rupture
Surgical intervention :1.Lens ECCE ,2.Cornea Wound repair,3.Vitreous Intravitreous abx injection
POD1   IOP: 27/15mm Hg OD/OS
AC: deep/silent OU ;Lens: aphakia OD ;Fundus: attached OD
Post-op 10 days  VA: 1/60 OD  IOP: 16/18mm Hg OD/OS
AC: deep/silent OU;Lens: aphakia OD;Vitreous and Fundus: attached retina
Case 3  (2023/01/30)  Age:  39 y/o Gender: Male   Mechanism:  使用砂輪機時，鐵絲刺入右眼，當天就診。
VA:  6/6 with 0,-0.75*105 OD, 6/5 0,-0.5*50 OS ;IOP: 12/13 mmHg OD/OS
Finding (OD): Cornea: mild SPK OD, clear OS
Sclera: penetrating wound over 3 o'c, 1-2mm to limbus, Seidel test(+)
A-C: deep/silent OU ;Lens：clear OU
Vitreous and Fundus: Pinkish disc and attached retina OD
Orbital CT: no obvious IOFB, nor hemorrhage
OP finding : penetrating wound over 3 o'c, 1-2mm to limbus with leaking
No traumatic cataract.
Surgical intervention : Corncoscleral wound repair ;2. Vitreous Intravitreous injection
POD1 : IOP: 14/15mm Hg OD/OS
Sclera:  penetrating wound, s/p suture, no leakage
AC: deep/silent OU ;Lens: clear OU
Fundus: attached retina with pinkish disc OD
Post-op  1wk ；BCVA: 6/6 OD, 6/5 OS   IOP: 8/11mm Hg OD/OS
AC: deep/silent OU ;Lens: clear OU ;Vitreous and Fundus: attached retina OD
Case 4  (2023/02/02)    Age:  67 y/o Gender: Male
Phx: RRD OS, s/p VT (2020/5, 2022/4) zonular dialysis with Pseudophakia->Aphakia OS, (sclera fixed IOL in 2020.4; IOL dislocation, s/p reposition in 2022.3 and removal in 2022.4)
Mechanism: falling down with Lt orbital contusion
VA: CF/30 cm OS ;IOP: N/A ;Others: Covid-19 infection
Finding (OS): Conjunctiva: SCH over nasal side OS ;Cornea: Iris protrusion from previous cornea wound OS ;A-C: deep OS ;Lens：Aphakia OS Vitreous and Fundus:attached with silicone oil tamponade OS
Orbital CT: silicone oil tamponade, aphakia, OS ;Blowout fracture at medial and inferior wall of left orbit
OP finding : Iris protrusion from previous cornea wound OS
Surgical intervention :1. Cornea Wound repair;2. AC irrigation
3. IVI abx
POD5 : IOP: 16 mmHg OS
Cornea: stitch at 10 OC, no iris incarceration, mild edema OS
A-C: deep OS, no hypopyon;Iris & Pupil: irregular OS ;Lens: Aphakia OS
Fundus:attached with silicone oil tamponade OS