Surgical treatment of severely traumatized eyes with no light perception.
OBJECTIVE
The purpose of this study was to evaluate the anatomical and functional outcomes of surgical intervention in severely traumatized eyes with no light perception (NLP).


METHODS
In this prospective interventional case series, 18 eyes of 18 patients with severe ocular trauma whose vision was documented as NLP and with relative afferent pupillary defect of 3 to 4+ underwent deep vitrectomy and other appropriate procedures 1 to 3 times.


RESULTS
Vision was NLP in all eyes at the time of surgery, which was performed 3 days to 14 days after the initial trauma. During a mean follow-up period of 20.5 +/- 5.2 months (range, 11-36 months), except for 1 case of phthisis, other eyes achieved acceptable anatomical and functional outcomes. Postoperative vision was NLP in 2 eyes (11.1%), light perception in 3 eyes (16.7%), hand motions in 4 eyes (22.2%), counting fingers in 3 eyes (16.7%), and 20/200 or better in 6 eyes (33.4%).


CONCLUSIONS
After eye trauma, NLP vision and relative afferent pupillary defect of 3 to 4+ alone may not be an indication for enucleation. Performing exploratory surgery within 14 days after the injury may salvage the globe and improve vision; this approach also entails positive psychologic effects for patients and relatives.
Heidari
Ebadollah
E
Department of Ophthalmology, Nikookari Eye Hospital, Tabriz Medical University, Tabriz, Iran. ebadolla_heidari@yahoo.com
Taheri
Nazli
N
D000293:Adolescent; D000328:Adult; D000368:Aged; D001766:Blindness / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015353:Eye Enucleation; D005129:Eye Foreign Bodies / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D015807:Eye Injuries, Penetrating / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011681:Pupil Disorders / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D014785:Vision, Ocular; D014821:Vitrectomy; D055815:Young Adult