Multi-Stage Reconstructive Surgery of the Eyeball with No Light Perception After Severe Open Globe Injury

Abstract

Lyubomyr M Lytvynchuk,1,2 Makar Ponomarov,1 Erick Carlos Reyna,1 Knut Stieger,1 Monika Andrassi-Darida1 1Department of Ophthalmology, University Hospital Giessen and Marburg GmbH, Campus Giessen, Justus-Liebig-University Giessen, Giessen, 35392, Germany; 2Karl Landsteiner Institute for Retinal Research and Imaging, Wien, 1030, AustriaCorrespondence: Monika Andrassi-Darida, Department of Ophthalmology, University Hospital Giessen and Marburg GmbH, Campus Giessen, Justus-Liebig-University Giessen, Friedrichstrasse 18, Giessen, 35392, Germany, Tel [phone], Fax: [phone], Email [email protected]: To analyze the visual and anatomical outcomes of multi-stage reconstructive surgery of the eyeball with no light perception (NLP) in patients after severe open globe injury (OGI).Patients and methods: In this retrospective consecutive case series study, medical records of patients with severe OGI with visual loss up to NLP, who were referred to our clinic between February 1, 2016, and March 30, 2021, were included. The analysis of epidemiologic data, type and severity of OGI, timing and type of surgical treatment, and anatomical and functional results was performed.Results: Nine patients met our inclusion criteria. The mean age was 52 years (range 34– 78 years). Mean follow-up was 24 months (range 1– 56 months). Estimated mean best corrected visual acuity (BCVA) was 2.92 LogMAR immediate after trauma, 2.27 LogMAR before reconstructive anterior segment surgery and 2.42 LogMAR at last follow-up. The functional gain after the primary repair was highly significant (p 0.005), but a non-significant gain was seen at the last follow-up. Retina reattachment was achieved in most of the cases (6/7, 85.7%), but these remained silicone oil dependent (5/6, 83.33%). In all cases, it was possible to prevent primary enucleation.Conclusion: The multi-stage reconstructive surgical approach allowed for saving the eyes and improved the functional and anatomical condition. Despite the severity of OGI and NLP, an early surgical intervention should be considered by experienced surgeons.Keywords: open globe injury, no light perception, multi-stage reconstructive surgery, vitreoretinal surgery, black diaphragm intraocular lens, retention sutures

Keywords

• open globe injury
• no light perception
• multi-stage reconstructive surgery
• vitreoretinal surgery
• black diaphragm intraocular lens
• retention sutures.