Surgical Treatment of Severely Traumatized Eyes with No Light Perception

To evaluate the anatomical and functional outcomes of surgical treantment in severely traumatized eyes with no light perception (NLP) vision. In this prospective interventional case series, 18 eyes of 18 patients with severe trauma and NLP vision and RAPD of 3-4+ admitted in Nikookari Hospital, Tabriz-Iran during 2002-2005 underwent deep vitrectomy and other appropriate procedures for one to three times and were followed for 11 to 36 months. All eyes had NLP vision at the time of surgery and underwent the operations 3-14 days after the injury. After mean follow up of 20.5 months, except for one case of phthisis, other eyes achieved acceptable anatomic and functional outcomes. Postoperative vision was NLP in one case due to orbital fracture and optic nerve disruption, light perception in three cases, hand motion in four cases, counting fingers in three cases and 20/100-20/200 or better in seven eyes. NLP vision with RAPD of 3-4+ alone may not be indication for enucleation. Performing exploratory surgery within 14 days after the injury may salvage the globe and improve vision, this approach also entails positive psychological effects on patients and relatives.