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T. Wiegand, F.C. Barouch; Visual Outcomes and Complications in Globe Injuries Due to Trauma With Wooden Material . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5036.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: The outcomes of globe injuries with wooden material have been limited largely to case reports. Here we characterize visual outcomes and complications in a series of 29 globe injuries due to trauma with wooden material presenting to a tertiary care hospital. Methods: Out of 1,190 patients that presented to the Eye Trauma Service of the Massachusetts Eye & Ear Infirmary over an 8 year period (1996–2004), 29 patients were identified with a history of globe injury with wooden material. These patients underwent surgical repair within 24 hours, received 36 hours of intravenous antibiotics, and were followed for at least 55 days postoperatively. Charts were retrospectively reviewed with respect to type and location of globe injury, visual acuity at presentation, postoperative visual acuity at 2–4 months, need for concomitant cataract surgery during open globe repair, need for additional surgery after open globe repair, and complications. Results: Patients ranged from 2 to 71 years of age (median 32) and 86% were men. Injuries occurred more frequently in the right eye (62%). Injuries from tree branches (62%) occurred more often than from wood pieces. Penetrating full–thickness lacerations (72%) were more frequent than partial thickness lacerations. Injuries limited to the cornea (Zone 1) accounted for 76% of the cases, injuries extending up to 5 mm posterior to cornea (Zone 2) accounted for 21%, and those more than 5 mm posterior to cornea (Zone 3) accounted for the remainder. Visual acuity at presentation (range light perception to 20/15) was < 20/200 in 62%, 20/50–20/100 in 14%, and > 20/40 in 24%. Intraocular foreign bodies were found in 24% of eyes. Concomitant cataract extractions were performed in 24% of eyes at the time of surgical repair. At follow–up (55–125 days) visual acuity was < 20/200 in 24%, 20/50–20/100 in 24%, and > 20/40 in 52%. Postoperatively, patients had no change in vision in 17% of cases, moderate visual gain (1–4 lines) in 48%, and large visual gain (>5 lines) in 34%. Additional surgery was required in 28% of eyes (24% cataract extraction, 7% retina surgery, 3% keratoplasty). Complications included 3% fungal keratitis, 3% wound leak, and 7% cystoid macular edema. There were no cases of endophthalmitis. Conclusions: Patients with globe injuries due to trauma with wooden material managed by prompt surgical repair and prophylactic antibiotics had in general a favorable visual prognosis with low rates of infection and complications. This series provides information that may be useful for clinicians in the evaluation of patients with these injuries.
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