97th DOG Annual Meeting 1999



S. Scommotau, A. Lambert, K. Pittasch

The functional outcome after penetrating injuries varies and mainly depends on the severity of the injury. Males were involved in 88% of the cases. The most frequent place of injury was the home.

Patients: Two patients suffering from a penetrating injury caused by working with a grinder were admitted to the department of ophthalmology of the University of Leipzig within one week. The preoperative visual acuity was 1,0 and 0,8; respectively. The first patient showed a metallic foreign body temporarily near the limbus. Ultrasonography verified that the foreign body continued into the vitreous body. In the second case a metallic wire pined out of the bulbus for 8mm. The anterior segment examination revealed a sanguination in the anterior chamber and a fibrin net had developed. The preoperative and postoperative findings were documented by phyotography and ultrasonography.

Results: The surgical primary repair and removal of the intraocular foreign body in both patients was performed in less than 6 hours after the injury and the intravenous antibiotic therapy was initiated. Using an exomagnet and pincers, a 14mm and a 25mm long wire (Ø 0.5mm) were extracted. Ophthalmoscopic investigation revealed a small retinal scar at 4.00 o`clock at the peripheral fundus (14mm wire). A preretinal hemorrhage superior to the optic disc as well as a small vitreous hemorrhage were detected (25mm wire). An endophthalmitis could not be detected clinically or using ultrasonography. When the patients were discharged they regained the visual acuity from admission.

Conclusions: After penetrating injuries good functional results can be achieved if the center of cornea and retina are not involved. Prevention requires education to ensure adequate protective measures are taken in potentially hazardous settings also when working at home.

Department of Ophthalmolgy of the University of Leipzig, Liebigstr. 10-14, 04103 Leipzig