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A.F. Laplante, B. Cinq–Mars, R.N. V. Dinh; Outcome of Severe Eye Traumas Following Combined Surgery of the Anterior and Posterior Segments . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5451.
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Purpose: Few reports in the literature have described the outcome of severe eye traumas. The visual prognosis depends on the structures being damaged, i.e. worst for posterior insults. The goal of our work was to review in our institution the evolution of eye traumas severe enough to require the simultaneous intervention of both an anterior segment and a vitreoretinal surgeon in the operating room. Methods: A retrospective analysis of cases occurring from 2001 to 2004 was undertaken. The outcomes studied were the visual acuity at 3 and 12 months and all the complications that occurred after the trauma. Results: We reviewed 31 combined surgeries of 28 patients (1 bilateral case and 2 cases of combined surgeries that were repeated twice). Of these 28 patients, 26 were males and 2 females. Their mean age at the time of the trauma was 41 years old. Most of them were operated within 24h of the trauma, either by a general ophthalmologist or at first under the setup of a combined surgery. For the few others, a longer delay was not associated with a worst visual prognosis. Numerous complications occurred following these severe traumas, the most frequent being retinal detachments. Although some patients reached a visual acuity at 3 months up to 20/20, the majority of them had a vision between 20/100 and light perception (LP), but their vision was improved compared to their pre–operative status. At one year, less data was available but the same trend toward low vision was still present. Among the cases studied, only one eye was enucleated (explainable) and no one was totally blind down to no light perception (NLP). Conclusions: Compared to the literature where considerable rates of blind and enucleated eyes were reported, we salvaged almost all the operated eyes and some patients ended with a functional vision. We are reporting an improvement in the outcome of these severe eye traumas as the surgical procedures have evolved in the last years.
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