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R.S. Thaker, N. Patel, W. Halperin, M. Zarbin, N. Bhagat; Anatomical and Functional Outcomes of Repair of Traumatic Ocular Penetrating Injuries . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3963.
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To assess the etiology, clinical findings, anatomic and functional outcomes of repair of traumatic ocular penetrating injuries that presented to the inner city university hospital at Newark, New Jersey, between 1998 and 2005.
Retrospective case series
200 eyes with penetrating globe injury were identified in the eight year period. Corneal laceration was identified in 75 eyes; corneal–scleral laceration in 99 eyes and scleral laceration only in 26 eyes. 143 eyes underwent initial corneal and scleral wound closure by anterior segment specialists. The remaining 57 eyes underwent pars plana vitrectomy with ruptured globe repair by retina specialists. Of 57 eyes, 42 were found to have intraocular foreign body: nails 14 (33%), metal 8 (19 %), BB pellet 8 (19%), glass 9 (21.4%), stone 2 (4.7%) and wood 1 (2.4%). The mean preoperative visual acuity of all 200 eyes was 20/500 (1.4 by logMAR scale) and the mean post–operative visual acuity after initial RG repair was 20/174 (0.95 by logMAR scale). The majority of patients sustaining ruptured globes (RGs) were young men who were injured secondary to work–related accidents, violence or sports. Ocular trauma in the elderly patients was mostly due to accidental falls.
Traumatic injuries are one of the leading causes of blindness in USA. These injuries can have varied clinical presentation. The visual prognosis depends on the location of the injury, presence of intraocular foreign body and presence of endophthalmitis. If the anterior segment is involved, the visual prognosis may be promising but if the posterior segment of the eye is involved, the anatomic and functional outcomes are not favorable. Despite the heterogeneity of injury mechanisms, advent of microsurgical techniques and successfully repaired eyes with trauma, involving both anterior and posterior segment, the visual results are still dismal. Preventive measures such as use of safety goggles during at–risk behaviors, may reduce the incidence of rupture globes in young men.
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