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EN
The heads-up surgery is becoming more and more common and acceptable as it eliminates restrictions imposed by the use of a standard microscope, and minimizes surgeon's fatigue, and allows surgery in much more natural and physiological positions of the body. It also does not affect the image quality and surgical technique. It is increasingly used not only in retinal and vitreous surgery but also in procedures preformed on the anterior segment of the eye. Preliminary observations of the results of surgical treatment of cataracts, posttraumatic changes, strabismus and bullous keratopathy with three-dimensional (3D) visualization technologies, confirmed the safety profile of treatments as compared to conventional methods. Besides, 3D imaging is distinguished by educational values and enables the performance of the light-out operation.
PL
Technika heads-up surgery staje się coraz bardziej powszechna i akceptowana. Pozwala ona wyeliminować ograniczenia narzucane przez stosowanie standardowego mikroskopu operacyjnego oraz minimalizuje zmęczenie, gdyż umożliwia operowanie w znacznie bardziej naturalnej i fizjologicznej pozycji ciała. Jednocześnie zaś nie wpływa negatywnie na jakość obrazu ani na technikę operacyjną. Znajduje coraz szersze zastosowanie nie tylko w chirurgii siatkówki i ciała szklistego, ale również przedniego odcinka oka. Wstępne obserwacje wyników chirurgicznego leczenia: zaćmy, stanów pourazowych, zeza oraz keratopatii pęcherzowej, z zastosowaniem techniki trójwymiarowej wizualizacji potwierdzają, że profil bezpieczeństwa zabiegu jest porównywalny z metodami konwencjonalnymi. Obrazowanie 3D wyróżnia się zaś walorami edukacyjnymi oraz możliwością wykonania zabiegu w trybie light-out surgery.
EN
Initial management in cases of suspected injury to the eyeball does not differ from the one adopted in other ophthalmic diseases. Only once the preliminary diagnosis is confirmed, a treatment strategy should be planned. It is important to take into account the general condition of the patient, the condition of the eye, and the possibility of its preserve. If a patient requires vitrectomy, small incision surgery is the preferred technique. In the case of total eyeball injury, optical centers of the eye lose their translucency, making examination of the eye fundus, diagnosis and treatment impossible. There are several options in such situations. They include: delayed treatment, open sky surgery, endoscopic surgery, and temporary keratoprosthesis. 7% of all open globe injuries are associated with the development of endophthalmitis. The management strategy in advanced endophthalmitis involves performing an urgent vitrectomy.
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