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Arne Viestenz, Andre Klamann, Gerrit Darkow, Udo Hennighausen, Achim Langenbucher, Friedrich Wienecke, Wolfgang Behrens-Baumann; Ocular Injury Due To High Pressure Water Jets. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5620.
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Eye injuries caused by hose stream for fire fighting are rarely reported. The clinical outcome of eyes injured by high pressure water jets is poor. The aim of this study is to identify the main cause of later surgical failure and will give the ophthalmic surgeon pearls for identification of major ocular damage.
Fifty-two pig eyes embedded in ballistic gel in an orbital model according to Viestenz & Behrens-Baumann were shot with high pressure water jets (5 bar up to 9.5 bar) from different working distances: 0.5 m, 2 m, 5 m and 8 m. Slit lamp photographs were taken and ultrasound examination was performed in each traumatized eye.
1) 8 controls vs. 44 traumatized eyes: No morphological damage in controls. Eyes injured by hose stream: retinal detachment 61% (p=0.001), ciliary body cleft 52% (p=0.006), lens injury 93% (p<0.001), choroidal rupture 25% (non significant =n.s.), retinal damage 75% (p<0.001). No globe rupture was observed.2) Conventional fire nozzle vs. bundled water jet of a fog nozzle (24 vs. 20 eyes): retinal detachment 67% vs. 55%, ciliary body cleft 54% vs. 50%, lens injury 92% vs. 95% (n.s.).3) distance between opening of nozzle and eye: 0.5 m/2.0 m/ 5.0 m: ciliary body cleft 100%/63%/33%, retinal tear/detachment: 100%/100%/42%
A careful history should be taken after water jet injuries. If the accident appeared in a distance of 2 m or less, the risk of a retinal break is 100%, and the risk of ciliary body cleft with choroidal detachment is between 63 and 100%. The surgeon should be aware to treat both: the hypotony with cyclopexy and the retinal break.
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