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Impressum
Classification and prognosis of visual acuity of penetrating ocular injuries
Hefner L., Uhlmann S., Pittasch K., Wiedemann P.
Klinik und Poliklinik für Augenheilkunde der Universität Leipzig, Liebigstr. 10-14, 04103 Leipzig
Objective: The pupose of this study was to find out if there is
a possibility to make a prognosis of the visual outcome at the first examination
from the type of injury (penetration, intraocular foreign body, perforation,
rupture) zone of injury and initial acuity. Methods: From 01.01.-31.12.2000
34 patients with penetrating ocular injuries were treated in the department
of ophthalmology of Leipzig. 77% of the patients were male, 23% female,
54% of the accidents happened in spare time, 46% at work. At the first
examination the patients were divided into different groups of visual
acuity I (>/= 0,5), II (0,4-0,2), III (< 0,2-1/40), IV (1/50-lux)
and V (nulla lux), type and zone of injury were detected.
Results: The mean follow-up was 110 ± 91 days. Patients
with penetrations (n=13) or intraocular foreign bodys (n=10) showed at
first examinaton much better visual acuity than patients with perforation
(n=2) and rupture (n=9). There was no significant difference between the
types of injury in subsequent surgical procedures. Postoperative 85% of
patients with penetration and 70% of patients with intraocular foreign
body reached visual acuity of group I or II, none patient was getting
blind. Both patients with a perforation belonged pre- and post-operative
to group IV of visual acuity. The unfavorable prognosis of visual acuity
of patients with rupture (100% in group IV and V) could significantly
be improved (44% of the patients reached group I and II) after surgical
repair, 1 patient belonged pre- and postoperative to group V.
Conclusion: Also after surgical repair penetration or intraocular
foreign bodys showed much better visual acuity than perforation or rupture.
According to our results the unfavorable prognosis of rupture and perforation
seems mainly to be attributed to a far posterior reaching original injury.