Visual and Anatomic Outcomes in Perforating Ocular Injuries

Abstract

Purpose: This article reports the presentation, management, and outcomes in patients suffering perforating ocular injuries. Methods: A retrospective review was conducted at a single ophthalmology Level 1 trauma center. Patients with evidence of traumatic ocular perforation, with surgical intervention attended by a single vitreoretinal surgeon (W.F.M.), were reviewed between 2009 and 2017. Results: Six eyes from 6 patients with perforating ocular injuries were studied. All patients were male, between ages 11 and 56 years. Perforation was the result of gunshots (3), other accidental injury (2), or surgical complication (1). Varying degrees of retinal detachments were seen in all 6 patients. Pars plana vitrectomy, with endolaser around posterior entry or exit wounds, was performed on average 21.7 ± 8.9 days from the time of injury (range, 0-58 days). In all cases with intraorbital foreign bodies, the foreign bodies were left in place. The most recent postoperative visual acuity ranged from 20/25 to counting fingers. Missile injuries tended to have poorer vision. All cases achieved full anatomic attachment at most recent follow-up. There have been no orbital complications related to retained intraorbital foreign bodies, including endophthalmitis, orbital infections, or mechanical strabismus. Conclusion: This study demonstrates successful anatomic outcomes of 6 cases of perforating ocular injuries. Visual outcomes were variable, though missile injuries demonstrated worse prognosis, whereas several nonmissile macula-involving cases achieved quite favorable results. Although traumatic perforating injuries generally have guarded visual prognoses, favorable results may be achieved in select scenarios.

Estudo Retrospectivo Em Pacientes Após Trauma Ocular Perfurante Associado a Dados Epidemiologicos E Prognóstico Visual No Centro Universitário Fmabc

“…Entretanto, no estudo europeu, os traumas relacionados às tarefas domésticas são prevalentes em 44,1 % das lesões, seguidas das relacionadas ao trabalho sem uso de equipamentos para a proteção individual e por último, relacionadas as práticas esportivas de crianças com idade entre 5 à14 anos. No entanto, ambos concordam que 90% das lesões oculares são evitáveis com uso de óculos de proteção 3-8. Todavia, o estudo realizado em Chicago, demonstrou que dos seis pacientes incluídos no mesmo, a média de idade foi semelhante, variando de 11 a 56 anos e a perfuração ocular, resultou de arma de fogo em primeiro lugar, seguida de outra lesão acidental ou complicação cirúrgica [7][8][9] .…”