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Sue Wei Ho, Rupesh Agrawal, Xiaoling Ou, Stephen C. Teoh; Surgical Treatment Of Severely Traumatized Eyes With Initial Visual Acuity Of No Light Perception. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5586.
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The objective of this study was to evaluate the anatomical and functional outcome of surgical repair of severely traumatized eyes with no light perception as initial visual acuity.
A retrospective review of medical records of all patients with surgical repair of open globe injury over the last ten years at a tertiary referral eye care centre in Singapore was conducted. Out of one hundred and seventy two eyes with open globe injury, twenty seven eyes with no light perception preoperative visual acuity were reviewed further.
Twenty seven eyes had no light perception as initial visual acuity. Median age was 39.62 yrs (range: 15-91yrs) with male predilection (85.18%). Surgical repair of all the 27 eyes was performed within twenty four hours of injury. Final visual acuity remained no light perception in 18 eyes (66.66%), improved to perception of light in 5 eyes (16.7%) and 6/45 in 2 eyes (7.40%) & 6/24 in 2 eyes (7.40%). The factors contributing to poor postoperative vision were presence of relative afferent papillary defect, posterior location of the wound, corneal scar in visual axis and associated vitreo-retinal trauma.
Loss of light perception is an important determinant of final visual outcome as seen in two third of patients in this series. However, one third had improved vision with 15% of patients reaching 6/45 or better. With proper counseling; if the patient accepts the potential for and inconvenience associated with the multiple surgeries as well as the modest chance for functional success, the ophthalmologist should pursue reconstruction, not enucleation.
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