Purchase this article with an account.
M. M. Pham, D. Xing, M. A. Zarbin, N. Bhagat; Functional and Anatomic Outcomes of Traumatic Ruptured Globe Injuries With No Light Perception Vision. Invest. Ophthalmol. Vis. Sci. 2007;48(13):683.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report functional and anatomic outcomes of traumatic ruptured globes (RG) that were no light perception (NLP) at the initial presentation to New Jersey Medical School, Newark, NJ.
Medical records of all RG patients were reviewed to identify those who presented with initial visual acuity (VA) of NLP between 1998-2006. Following data was collected: demographics, etiology, mental status at presentation, extent of injury, presence of intraocular foreign body (IOFB), past ocular history, surgical procedures performed, anatomic outcome and final VA.
Of 343 patients with RGs who presented to University Hospital (UH) between 1998-2006, 32 eyes of 32 patients had presenting VA of NLP. Two patients were excluded due to NLP vision prior to RG. Of the remaining 30 patients, 5 were female, 25 were male; median age was 37 years, mean age was 34.8 years (range, 13 - 77 years). Racial demographics were African American (14), Hispanic (9), Caucasian (4), Asian (2), and unknown (1). Etiologies included assault (11), gunshot wound (3), fall (3), stab wound (2), nail (2), motor vehicle accident (2), unknown (2), and others (5). One gunshot wound patient also had an IOFB. The extent of laceration included cornea only (6), sclera only (11), and corneal-scleral (13). Of these 30 patients, 4 had primary enucleation, 25 RG underwent laceration repair and 1 underwent RG repair with pars plana vitrectomy (PPV), pars plana lensectomy, and removal of IOFB. 10 of 26 patients remained NLP and subsequently underwent secondary enucleation. 5 of 16 remaining patients underwent subsequent PPV.The 16 patients without enucleation had a mean follow-up of 10 months (range, 1 day - 7 years). VA were NLP (9), light perception (3), hand motion (1), 20/400 (2), 20/100 (1). The average age of patients with a final VA of NLP (Group A) was 35.9 years; with a final VA better than NLP (Group B) was 35.0 years. The mental status of all patients at presentation was intact except for 1 patient in Group A and 2 patients in Group B, who were poorly cooperative. However, all patients were capable of providing their own history. Of the patients in Group B, only one had a history of ocular disease. Furthermore, 4 patients in Group B underwent secondary vitreoretinal surgeries. The etiologies and extent of the laceration between the two groups were also very similar.
7 of 30 (23%) patients with RG injuries who presented with NLP vision had VA, LP or better after RG surgeries. 3 patients (10%) had VA in the 20/100 - 20/400 range. Patients who present with NLP vision should undergo aggressive management measures since upto 10% may have some useful vision.
This PDF is available to Subscribers Only