title: Traumatic corneal laceration with associated lens capsule disruption: a retrospective study of 77 clinical cases from 1999 to 2009.
abstract: OBJECTIVE
  Examine prognostic factors that may indicate when surgical lens removal is indicated to prevent vision-threatening complications in patients presented following traumatic perforating corneal laceration with associated lens capsule disruption.
  
  
  METHODS
  Seventy-seven patients (10 cats and 67 dogs) were evaluated with this injury; of these, 47 were presented acutely and treated surgically and/or medically. Successful outcome was defined as functional vision in the treated eye.
  
  
  RESULTS
  The 47 patients with acute injuries were divided into 3 treatment groups A-C for comparison; A - corneal repair/lens removal (n = 15), B - corneal repair/no lens removal (n = 9), C - medical management (n = 23). Groups A and B showed a significantly greater rate of vision loss compared to Group C that was most obvious greater than 18 months post-injury (P = 0.029 and 0.0097, respectively). Cox proportional hazards regression analysis found a significantly higher increased rate of vision loss in Group A (HR = 4.5; P = 0.023) and a higher but nonsignificant increased rate of vision loss in Group B (HR = 3.0; P = 0.23) compared to Group C after controlling for age and cause of injury. The length of the corneal laceration and time interval from injury to referral were also relevant prognostic factors.
  
  
  CONCLUSIONS
  Medical management is an appropriate therapy for patients of all ages suffering perforating corneal injuries with associated lens capsule disruption. Patients with corneal injuries requiring surgical repair or managed by lens removal following corneal repair suffered vision-threatening complications approximately 3 to 4.5 times the rate of patients treated by medical management, respectively. Favorable prognostic signs for treatment by medical management include good corneal wound apposition and a formed anterior chamber without uveal prolapse or continued aqueous leakage.
authors.affiliation: Animal Eye Clinic, 5800 W. Interstate 20 Hwy. Suite #120 Arlington, TX 76107, USA. mpaulsen@att.net
authors.forename: Michael E
authors.initials: ME
authors.lastname: Paulsen
authors.forename: Philip H
authors.initials: PH
authors.lastname: Kass
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000473:pathology / Q000601:surgery; D002415:Cats / Q000293:injuries*; D003315:Cornea / Q000601:surgery; D065306:Corneal Injuries; D004283:Dog Diseases / Q000473:pathology / Q000601:surgery; D004285:Dogs / Q000293:injuries*; D005260:Female; D007903:Lens Capsule, Crystalline / Q000473:pathology* / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000662:veterinary*