K 389
Eyelid trauma epidemiological aspects
H. Herzum, P. Holle, C. Hintschich
Introduction: To present epidemiological data on eyelid trauma that appear rarely in the literature.
Methode: Medical records of 180 patients given surgical treatment for eyelid injuries between 1994 - 98 were evaluated. Mechanisms of trauma were placed in 10 categories. Clinical findings of eyelids and eyeball, the surgical procedure and complications during wound healing were considered.
Results: Of 180 patients 96 suffered blunt trauma. Thereof 30 were due to sudden falls,, 23 to violence, 21 to manual work, 7 to motor vehicle accidents and 6 to sports. From 26 cutting injuries caused by glass, 12 were originated by broken spectacles, 8 were based on sudden falls, 4 caused by violence and only 2 by car accidents. The remaining 58 patients suffered various mostly trivial traumas. Clinically 85 patients showed injuries of the upper eyelid, 55 of the lower and 40 of both lids. The lid margin was affected in 43 patients, the lacrimal drainage system in 28. Thirty-four patients had wound contamination, 19 foreign bodies and 13 loss of tissue. Accompaning injuries of the face was noticed in 16 patients, of the eyeball in 79 patients. Of the latter 31 were superficial, 36 were eyeball contusions of varying severity, 12 were perforations or ruptures. Four patients had additionally orbital bone fractures. Mean time from injury to surgery was 3.3 hours. One hundred patients needed simple skin suturing, 26 sutures to skin and subcutaneous tissue including orbicularis and levator muscle, 43 readaption of the lid margin and 24 repair of the canalicular system. Post-operatively only one patient developed a necrosis and one an infection.
Conclusions: In eylid trauma, the lid margin is affected in 24%, the lacrimal drainage system in 16% of all injuries. Our data also show a high association (44%) of eyelid injuries with trauma to the eyeball. This emphasizes the necessity of eyelid injuries being treated primarily by an ophthalmic surgeon, although difficult primary reconstructions and early complications are relatively rare
Department of Ophthalmology, Ludwig-Maximilians-University Munich, Mathildenstr. 8, 80336 Munich