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Yi Lai, Alain Bauza, Paul Langer, Suqin Guo, David Chu, Albert Khouri, Robert Fechtner, Roger Turbin, Neelakshi Bhagat; Characteristics and Management of Traumatic Eyes with Full Thickness Corneal Lacerations. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4438. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the characteristics, management, posterior segment complications, and outcomes of traumatic eyes with full thickness corneal lacerations.
Retrospective chart review. Medical records of all eyes that presented to the University Hospital, Newark, NJ with corneal lacerations between 2001 and 2010 were analyzed. Data on age, gender distribution, type of injury, zone of injury, pre-operative visual acuity (VA), post-operative VA, lens status, vitreous hemorrhage (VH), retinal detachment (RD), hemorrhagic choroidals (HC), intraocular foreign body (IOFB), dislocated lens, retained lens fragments, endophthalmitis, proliferative vitreoretinopathy, enucleation, penetrating keratoplasty (PKP) and pars plana vitrectomy (PPV) were recorded.
270 patients with corneal lacerations were identified. The demographics and characteristics of these eyes are recorded below in a table. Posterior segment (PS) complications were seen in 105 (38.9%) of 270 eyes: 70 (66.7%) eyes were noted to have PS complications at presentation (within one week of presentation), 19 (18.1%) developed early PS complications (between one and six weeks), and 16 (15.2%) developed late complications (after six weeks). Comparison of parameters are outlined below: Among eyes with PS complications, 24 (22.9%) developed VH only, 23 (21.9%) developed HC along with other complications (VH, RD, IOFB, macular hole, dislocated lens, or proliferative vitreoretinopathy), 52 (49.5%) developed RD along with other complications (VH, HC, IOFB, macular hole, dislocated lens, subluxated lens, epiretinal membrane, or proliferative vitreoretinopathy). Five (4.8%) eyes developed endophthalmitis. Of 24 eyes with VH only, 9 (37.5%) underwent PPV, while 15 (62.5%) spontaneously resolved. Of 23 eyes with HC, 9 (39.1%) underwent choroidal drainage, 7 (30.4%) spontaneously resolved, 5 (21.7%) underwent PPV (for concurrent complications), and 2 (8.7%) were enucleated. Of 52 eyes with RD, 17 (32.7%) had anatomic success with one PPV, and 12 (23.1%) had anatomic success with two or more PPV, with overall anatomic success of 29/32 (90.6%).
A large number of eyes (~40%) with full-thickness corneal lacerations had PS complications; half of these eyes had retinal detachment. Overall, 8.5% of eyes underwent PKP. Eyes with PS complications were less likely to achieve a more favorable post-operative VA than eyes without PS complications.
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