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At least 19 recordsLinked to original sources
PubMed1981

Vitrectomy in penetrating eye injury. Results of a controlled trial of vitrectomy in an experimental posterior penetrating eye injury in the rhesus monkey.

A controlled trial of pars plana vitrectomy for posterior penetrating eye injury was done in rhesus monkeys. After standard injury, each eye was allocated randomly into a treatment or control group. Treatment groups (ten eyes each) had vitrectomy at 1, 14, or 70 days after injury. The control group had 15 eyes. The same techniques were employed as in human eyes. Surgical objectives were lensectomy, then complete posterior vitrectomy and excision of the anterior vitreous to within 1 or 2 mm of the surface of the peripheral retina and pars plana. Results from this controlled trial provide strong support for the effectiveness of vitrectomy techniques in managing selected posterior penetrating injuries in human eyes and in preventing the complication of traction retinal detachment.

Animals↗
PubMed1991

Work-related penetrating eye injuries.

A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over 5 years (January 1st 1982 to December 31st 1986) was undertaken. There were 258 penetrating eye injuries of which 69 (26.7%) were due to work-related accidents. All were men and 52 (75.4%) of them were under the age of 40 years. Hammering and chiselling were the commonest activities at the time of the injury and accounted for 25 cases (36.2%). Thirty-six patient (52.1%) had intraocular foreign bodies. Thirty-six patients (52.1%) achieved a good visual result (6/12 or better) and 9 had no perception of light, 7 of whom had enucleations. The period of inpatient treatment ranged from 1 to 26 days. From the analysis of the activities at the time of the injury, 61 injuries (88.4%) may be considered to be preventable with appropriate eye protection.

Accidents, Occupational↗
PubMed1994

Intravenous cefazolin in penetrating eye injuries. I. Effects of trauma and multiple doses on intraocular delivery.

The poor intraocular penetration of systemically administered antibiotics has raised questions regarding their usefulness as prophylactic agents in the management of penetrating eye injuries. Cefazolin was administered intravenously to rabbits with penetrating eye injuries to determine the influence of trauma on ocular pharmacokinetics. Following a standardized penetrating eye injury in 27 New Zealand white rabbits, animals were divided into three groups that received either three, six, or nine doses of intravenous cefazolin every 8 h. Cefazolin levels were then measured in the traumatized eye, the non-traumatized (control) fellow eye, and in the serum of each animal. In the three treatment groups vitreous concentrations of cefazolin were significantly higher in traumatized eyes than in the non-injured eyes. After three doses, vitreous concentrations of cefazolin in traumatized eyes averaged 9.1 mg/l; mean concentrations of cefazolin in non-injured eyes were 0.6 mg/l (P < 0.0002). After six doses of intravenous cefazolin, vitreous concentrations in traumatized eyes averaged 7.3 mg/l; cefazolin levels in non-injured eyes were 0.6 mg/l in the non-traumatized eyes (P < 0.0005). After nine doses, vitreous cefazolin concentrations in traumatized eyes averaged 9.7 mg/l, while mean levels in the non-traumatized eyes were all 0.05 mg/l (P < 0.0002). This work suggests that penetrating injuries of the eye alter ocular pharmacokinetics, resulting in high intraocular concentrations of systemically administered cefazolin.

Animals↗
PubMed1999

Penetrating eye injury in war.

The percentage of penetrating eye injuries in war has increased significantly in this century compared with the total number of combat injuries. With the increasing use of fragmentation weapons and possibly laser weapons on the battle-field in the future, the rate of eye injuries may exceed the 13% of the total military injuries found in Operations Desert Storm/Shield. During the Iran-Iraq War (1980-1988), eye injuries revealed that retained foreign bodies and posterior segment injuries have an improved prognosis in future military ophthalmic surgery as a result of modern diagnostic and treatment modalities. Compared with the increasing penetrating eye injuries on the battlefield, advances in ophthalmic surgery are insignificant. Eye armor, such as visors that flip up and down and protect the eyes from laser injury, needs to be developed. Similar eye protection is being developed in civilian sportswear. Penetrating eye injury in the civilian sector is becoming much closer to the military model and is now comparable for several reasons.

Adult↗
PubMed1994

Penetrating eye injuries in young children.

BACKGROUND: Penetrating eye injuries remain an important cause of blindness among children. METHODS: Thirty consecutive children, nine years of age or younger, were treated for penetrating eye injuries. Twenty-two (73%) of those patients studied were male and 8 (17%) were female. The average age of the patients was 4.6 years. Sharp objects accounted for the majority of injuries (83%). Twenty (66%) eyes required only primary repair and 10 (33%) eyes required secondary lensectomy and vitreous surgery, which was done within 10 days of the primary repair. Length of follow-up ranged from 6 months to 48 months, and 5 patients were lost to follow-up. RESULTS: Visual acuity of 20/40 or better was achieved in 13 (72%) of the 18 patients requiring only primary repair. Stereopsis was present in 13 (87%) of these patients. Of those patients that underwent secondary lensectomy with anterior or pars plana vitrectomy, 42% had visual acuity of 20/100 or better. None had stereopsis. CONCLUSION: Young children with penetrating eye injuries requiring only primary repair may achieve excellent visual recovery, whereas those with traumatic cataract necessitating lensectomy and vitreous surgery have a less favorable outcome because of more severe injury and subsequent amblyopia.

Amblyopia↗
PubMed2004

[Prognosis of corneal transplantation after penetrating eye injury].

BACKGROUND: The success of penetrating keratoplasty (PKP) after penetrating eye injuries is often worse than in keratoplasty with Fuchs' endothelial dystrophy. However, comparable investigations are rare. Therefore, we have retrospectively analyzed the results and complication rates of PKPs in patients who experienced penetrating eye injuries. PATIENTS AND METHODS: Between 1990 and 1997 forty-four patients who received a corneal transplant at Kiel University Eye Hospital after penetrating eye injury (study group S) were analyzed. 29 patients were re-examined (visual acuity testing, slit lamp microscopy, applanation tonometry, stereo testing, corneal TMS topography, keratometry, endothelial microscopy, perimetry, indirect retinoscopy, testing of the retinal visual acuity and probatory contact lens fitting). Postoperative follow-up ranged between 1 and 6 years (median 3 years). The results were compared to a group of corneal grafts performed in patients with Fuchs' endothelial dystrophy (K, n = 18 patients, 25 eyes, median follow-up 2.8 years). RESULTS: 38males and 6 women had had a bilateral visual acuity of 0.8 or better before the accident, except for three cases. At the time of eye injury the patients' age ranged from 4 to 76 years. The eye trauma was caused by splinters of metal (45 %), glass (20 %), wood (16 %) or stone (11 %). In 73 % of the cases the injury was confined to the anterior segment of the eye (S1). The posterior part of the eye was involved in 27 % (S2). BCVA of S before keratoplasty (KP) was 1/15 on average (K 0.2), at least one year after KP 0.25 (K 0.4); post KP S1 was better than S2 (p = 0.0234), and K better than S (p = 0.0009). In group S 29 patients received a graft at random because of a central corneal scar, 14 patients received an HLA-typed graft with 2.3 mismatches on average. 93 % of the grafts (41 patients) were clear at the last examination, 8 patients showed rejection episodes, half of them were reversible. 5 patients received a second graft because of an irreversible rejection or endothelial decompensation. BCVA improved by at least one line in 84 % in S (K 92 %). BCVA was unchanged after KP in 6.8 % (K 8 %). In 9.1 % of S BCVA after KP was worse (K 0 %). 32 out of 44 patients had a BCVA of 0.1 or better after the last check-up, 13 out of 44 patients presented with a BCVA of 0.5 or better (K40 %). 15 out of 29 patients separately tested showed stereopsis compared to 8 preoperatively in S. In 48 % of the patients studied stereovision could not be restored. 82 % of the patients suffered from topographical irregular astigmatism in S, the superficial geometry of recipient's cornea seems relevant for astigmatism of the graft. Frequent postsurgical complications consisted of secondary glaucoma (S 27 %, K 4 %), immunological rejections (S 18 %, K 0 %), and amblyopia (S 14 %, K 0 %). CONCLUSION: Compared to patients with Fuchs' dystrophy the results of grafting after eye injuries are significantly worse. This relates to BCVA, astigmatism, frequency of secondary glaucoma and graft rejection.

Adolescent↗
PubMed1989

Penetrating eye injuries.

A review of all penetrating eye injuries treated at the Manchester Royal Eye Hospital over four years (1 January 1982-31 December 1985) was undertaken. A total of 202 penetrating eye injuries were seen of which 68 (34%) were in children under the age of 15 years. Airgun, dart, and knife injuries accounted for 28 (41%) of the injuries. Thirty seven patients (54%) achieved a good visual result (6/12 or better) and eight (12%) had enucleations. The period of inpatient treatment ranged from two to 18 days. From the analysis of the activities at the time of the injury, many of the injuries can be considered to be preventable.

Adolescent↗
PubMed2002

The epidemiology and diagnosis of penetrating eye injuries.

UNLABELLED: It is estimated that there are 3.1 penetrating eye injuries per 100,000 person-years in the United States. OBJECTIVES: To evaluate the epidemiology of penetrating eye injuries and to identify physical examination findings that facilitate the diagnosis and ophthalmologic referral of patients with these injuries. METHODS: This was a retrospective chart review of emergency department patients with penetrating eye injuries seen for evaluation from July 1987 to January 1999. The setting was a tertiary referral, university hospital. Three hundred eighty-four patients with 390 penetrating eye injuries were enrolled; 56% were transferred from outlying hospitals. RESULTS: Penetrating eye injuries were seen almost three times per month. Eighty percent of the injuries occurred in males, and the mean age was 29 years. Twenty-five percent of the patients had used alcohol in the period immediately preceding the injury. Final visual outcome was 28% with enucleation, "no light perception" (NLP) in 10%, light perception to 20/200 in 24%, and light perception of 20/200 or better in 38%. Poor visual outcome was associated with poor initial visual acuity, alcohol use, and delayed presentation (p = 0.036, 0.025, 0.036, respectively). Gun-related injuries caused 33% and motor vehicle crashes (MVCs) caused 21% of the worst outcomes (enucleation or NLP). In MVCs where seat belt use was reported, 71% of injured patients were unrestrained. The most common initial physical findings were hyphema (76%), abnormality of the pupil or uvea (94%), and initial visual acuity worse than 20/200 (77%). All patients had at least one of these findings. Complications occurred in 25% of cases, most commonly traumatic cataract or infection. Complications occurred more commonly in those patients transferred than in those presenting directly (p = 0.002). CONCLUSIONS: Penetrating eye injuries are relatively common, occur predominantly in young males, and often result in poor visual outcome in the affected eye. Motor vehicle crashes, alcohol use, and fire-arm use are associated with more severe injuries.

Accidents, Traffic↗
PubMed2006

[Endophthalmitis in war and peace penetrating eye injuries].

BACKGROUND/AIM: Nowadays, eye injuries are a leading cause of one-eye disease or blindness worldwide. The aim of this study was to comparatively analyze the frequency of endophthalmitis following war and peace eye injuries. METHODS: All the patients went throught the detailed ophthalmologic examinations, prophylactic antibiotic treatment, and pars plana vitrectomies (VPP), or other required surgical interventions. RESULTS: Inside the period from 1991 to 1998, 647 patients with eye injuries were hospitalized, out of which 500 with penetrating eye injuries. In the period 1999-2004, 611 patients with eye injuries, were treated, out of which 297 had penetrating eye injuries. Out of 500 patients with war penetrating eye injuries, in 286 of the cases intrabulbar foreign bodies (IFB) were detected. The signs of endophthalmitis were observed in 26 eyes (5.2%) at admission. Out of totally 297 peace penetrating eye injuries, 196 (66%) were IBF. In 25 eyes (8.4%) endophthalmitis was observed. CONCLUSION: In our study, the frequency of posttraumatic endophthalmitis following penetrating war eye injuries was relatively low, even lower than the frequency of endophthalmitis following peace eye injuries.

Adolescent↗
PubMed1979

Experimental posterior penetrating eye injury in the rabbit. I. Method of production and natural history.

A technique has been developed which produces an experimental posterior penetrating eye injury that reproducibly results in traction retinal detachment in rabbit eyes. The standard injury is an incision through the pars plana with vitreous prolapse and incarceration; the wound is then carefully closed with microsurgical techniques. It appears that blood in the vitreous is an essential factor in the development of vitreous traction and of traction retinal detachment. The model, which has been successfully transferred to Rhesus monkey eyes, is considered useful for further histological, electromicroscopical, electrophysiological, and ultrasound studies of posterior penetrating injuries of the eye. Our immediate goal is to assess in a controlled experiment whether pars plana vitrectomy can interrupt the sequence of events leading to traction retinal detachment after a posterior penetrating injury.

Animals↗
PubMed1991

Management of retinal detachment after penetrating eye injury.

Between December 1981 and April 1989 the authors operated on 61 eyes presenting with retinal detachment after penetrating eye injury. Air or expanding gases were used for retinal tamponade. The follow-up between complete gas absorption and last examination ranged from 8 months to 8 years (mean, 29 months). Retinal reattachment was achieved in 50 eyes (81.9%). Anatomic success was achieved by a single operation in 43 eyes (70.5%). A postoperative visual acuity of 20/40 or better was achieved in 46% of the eyes. The factors found to influence the postoperative outcome adversely include (1) association of severe blunt trauma (P less than 0.05), (2) anterior proliferative vitreoretinopathy (PVR) involving two or more quadrants (P less than 0.01), and (2) retinotomies (P less than 0.007).

Adolescent↗
PubMed1988

Penetrating eye injuries in road traffic accidents.

A review of all penetrating eye injuries treated by the Manchester Eye Hospital over four years (1 February 1982-31 January 1986) was undertaken. One hundred and ninety-six penetrating eye injuries were seen, of which 16 (8.2%) were due to road traffic accidents. Eight patients (nine eyes) were seen in the 12 months prior to the introduction of the seat-belt legislation on 1 February 1983. None of these patients was wearing a seat-belt whereas two of the eight patients (10 eyes) seen after the seat-belt legislation were. Both these patients suffered severe visual loss due to intraocular glass from shattered windscreens. Three patients had bilateral penetrating eye injuries, one before and two after the seat-belt legislation. Two of the nine eyes involved prior to the legislation and three of the 10 eyes after the legislation had an eventual visual acuity of 6/12 or better. In the majority of patients, failure to wear seat-belts or defective use is to blame. Flying glass from shattered toughened windscreens is a preventable danger. Nine of the 16 patients were first seen in the general accident and emergency department and, of these, seven did not have visual acuities recorded prior to referral to an ophthalmologist. The importance of measurement of the visual acuity and detection of an afferent pupillary defect is stressed based on these findings.

Accidents, Traffic↗
PubMed1985

Effect of urokinase on posterior penetrating eye injuries.

We studied the effect of urokinase on the natural course of posterior penetrating eye injury in an animal model that consistently results in late tractional retinal detachment. A standard penetrating injury was performed on both eyes of 20 rabbits. Each eye received 0.4 mL of heterologous rabbit plasma. Then 10 000 U of urokinase was injected in one randomly chosen eye of each animal; an equal volume of balanced salt solution (BSS) was injected in the other. By 5 to 6 weeks after the surgery 13 (65%) of the 20 urokinase-injected eyes and 15 (75%) of the 20 BSS-injected eyes showed retinal detachment; the proportions are not significantly different. Gross and microscopic study of the enucleated, sectioned eyes failed to reveal any features distinguishing the control and urokinase-treated eyes. Thus, urokinase did not appreciably alter the natural course of development of late tractional retinal detachment after posterior penetrating eye injury.

Animals↗
PubMed1992

Penetrating eye injuries related to assault. The National Eye Trauma System Registry.

From 1985 to 1991, 648 cases of assault-related penetrating ocular injury were reported to the National Eye Trauma System Registry. We examined the circumstances surrounding and initial clinical findings related to this case series of injuries. Eighty-three percent of the patients were male. The median age was 28 years; 77% were younger than age 40 years, and 17% were younger than age 20 years. The ocular injury was part of multiple trauma in 34% of cases. There was evidence of alcohol and illicit drug use by at least 48% and 6% of the injured persons, respectively. Seventeen percent of the injuries involved powder or nonpowder firearms. Fists, glass fragments, metal rods or pipes, knives, and scissors were among the other objects causing injury. Posterior segment trauma, which occurred in 70% of cases, included vitreous hemorrhage (40% of cases), retinal detachment (11%), presence of intraocular foreign bodies (6%), and optic nerve damage (4%). The initial visual acuity after injury was hand motion or worse in 74% of the cases. Strategies to prevent such injuries focus on the origins of violence in general and are more difficult to devise than strategies to prevent eye injuries in other settings. Public health efforts to reduce the use of alcohol, drugs, and firearms may reduce the incidence of these injuries.

Adolescent↗
PubMedDate not supplied

Characteristics and causes of penetrating eye injuries reported to the National Eye Trauma System Registry, 1985-91.

Ocular trauma is one of the most important preventable causes of visual impairment. The National Eye Trauma System was developed to provide optimal clinical care for severe ocular injuries, to foster research on eye injury, and to increase awareness of ocular trauma as a public health problem. From 1985 through 1991, the National Eye Trauma System Registry collected data on 2,939 cases of penetrating eye injury reported by ophthalmologists at 48 collaborating eye trauma centers in 28 States and Washington, DC. Eighty-three percent of the cases involved men; the median age of the patients was 27 years, ranging from 1 to 92 years of age. Seventy-seven percent of the injuries were unintentional, 22 percent were the result of assault, and 1 percent were self-inflicted. In 62 percent of the cases studied, the injured person's initial best corrected visual acuity in the injured eye was the ability to perceive hand motion, or worse. The settings in which the injuries occurred included the home (28 percent), the worksite (21 percent), at recreation (11 percent), and in transportation (8 percent). At the time of the injury, 1.5 percent of the injured persons were wearing safety glasses and 2.9 percent were wearing nonsafety glasses. There was evidence of definite or possible alcohol use by at least 24 percent of the injured persons and illicit drug use by 8 percent. The most frequent types of tissue damage included corneal or scleral laceration, traumatic cataract, intraocular foreign body, vitreous hemorrhage, and prolapse of intraocular tissue. Analyses of the causes and characteristics of ocular injuries reported to the National Eye Trauma System Registry will help identify high risk settings for such injuries. Results will be used to develop and implement interventions that will reduce the incidence of eye trauma.

Adolescent↗
PubMed2003

Preliminary experience of combined peri- and retrobulbar block in surgery for penetrating eye injuries.

BACKGROUND AND OBJECTIVE: Regional anaesthesia has not been recommended as an anaesthetic method for penetrating eye injuries because it is suspected to aggravate the injury already present. After having successfully managed the treatment of a penetrating eye injury under combined peri- and retrobulbar block in an ASA IV patient, it was decided to evaluate this anaesthetic method further in the treatment of such emergency cases. METHODS: Twenty adult patients with penetrating eye injuries with a maximum wound length of 8 mm extending up to 4 mm posteriorly from the limbus were operated on under combined peri- and retrobulbar anaesthesia. Eighteen patients receiving general anaesthesia served as controls. RESULTS: The mean (range) volume injected for a satisfactory peribulbar retrobulbar block was 7.4 (6.5-8.0) mL, six patients needed an additional retrobulbar injection before surgery (2.9, range 2-4, mL). All patients receiving regional anaesthesia were satisfied with the anaesthetic method and the surgeons considered the surgical conditions as good. No problems relating to local anaesthesia were observed or reported by any of the patients. CONCLUSIONS: In the hands of an experienced anaesthesiologist and under certain conditions, regional anaesthesia appears to be suitable for adult patients having penetrating eye injuries.

Adolescent↗
PubMedDate not supplied

Childhood penetrating eye injuries.

We reviewed 41 children with penetrating eye injuries from birth to 15 years of age between August 1982 to May 1990. Male to female ratio was 3.56:1. Thirteen (33%) cases resulted in monocular blindness. The distribution of penetrating injuries was based on the site of perforation: corneal, corneoscleral and scleral groups. The commonest cause of injury was child related from a thrown object (42%) and hazardous toys (21%).

Adolescent↗
PubMed1994

Clostridium bifermentans panophthalmitis after penetrating eye injury.

BACKGROUND: Intraocular and orbital anaerobic infections usually result from penetrating eye injuries with soil-contaminated foreign bodies. The outcome of these infections almost always has been loss of the globe, despite appropriate antibiotic and surgical treatment. The most prevalent etiologic microbe of anaerobic panophthalmitis is Clostridium perfringens. CASE REPORT: To the authors' knowledge, this is the first report of panophthalmitis caused by Clostridium bifermentans after penetrating eye injury. The patient had severe signs and symptoms of intraocular and orbital infection, with early total loss of visual function. Parenteral and intravitreal therapy with penicillin and clindamycin, administered according to antibiotic sensitivity studies of cultures from the anterior chamber and vitreous, did not restore vision. CONCLUSIONS: Due to the early devastating outcome, penetrating eye injuries with soil-contaminated foreign bodies should be regarded as being at high risk for clostridial infection and should be treated promptly with vitrectomy and antibiotic therapy for aerobic and anaerobic infection.

Adolescent↗