Purchase this article with an account.
Luis G Leon, Neelakshi Bhagat, Alain Bauza; Open globe injuries caused by elastic cords: A 13 year retrospective review. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3848.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To describe characteristics and outcomes of patients with open globes caused by elastic cord injuries in a large level 1 trauma center.
Retrospective review of all open globes at a tertiary eye center over a 13 year period. 8 patients with ruptured globes cause by elastic cords were identified. Demographics, ophthalmic findings, and outcomes were evaluated. Eye injuries were divided based on the BETT System, zone I wounds limited to the cornea and limbus, zone II if they involve the anterior sclera within 5 mm of the limbus, zone III if they involve the sclera 5 mm posterior from the limbus.
The patients' mean age was 37(range 25-52 years).All patients were male. 3 hispanic, 2 Caucasian, 3 African American. No patients had significant past eye history. All injuries were penetrating. The area of rupture was classified as Zone 1(3), Zone 2(1), Zone 3(4). Initial BCVA of the affected eyes was 20/40(1), 20/200(1), HM(2), LP(2), NLP(1). All underwent surgical repair within 24 hours of presentation. No patients developed endophthalmitis,3 presented with hyphema, 4 with lens capsule rupture and traumatic cataract,6 patients presented with RD and 1 developed an RD 6 years afterwards, 5 presented with VH, 3 presented with choroidal hemorrhage.6 of the ruptured globes were caused by the metallic end of bungie cords, 2 were caused by direct hit with the flexible part, 6 of the accidents occurred in construction sites, 1 while transporting home goods and 1 while working at home. In addition to primary repair, all patients required additional surgeries, 6 of them required PPV for RD or VH. 3 of the patients required PKP, 4 required cataract removal, 1 had IOL implanted afterwards. 1 patient required strabismus surgery. One of the eyes underwent secondary enucleation due to a painful,blind eye.Final visual acuity was LP (1), HM (2), 20/20(1), 20/50 (1), 20/100 (1), 20/400(1).
This study demonstrates that in cases of ruptured globes caused by elastic cord trauma there is a wide variety of final visual acuities that not necessarily correlate with presenting visual acuity. Most times the injury occurs at work. Most patients with trauma caused by an elastic cord usually need additional surgeries in order to achieve good anatomical outcome. The most common secondary surgery is PPV which is needed to repair retinal detachments and vitreous hemorrhages that are commonly caused by this mechanism of injury.
This PDF is available to Subscribers Only