Surgical Treatment of Severely Traumatized Eyes with No Light Perception

PURPOSE: To evaluate the anatomical and functional outcomes of surgical intervention in severely traumatized eyes with no light perception (NLP). METHODS: In this prospective interventional case series, 18 eyes of 18 patients with severe ocular trauma whose vision was documented as NLP and with relative afferent pupillary defect (RAPD) of 3-4+ underwent deep vitrectomy and other necessary procedures once to three times. RESULTS: Vision was NLP in all eyes at the time of surgery which was performed 3-14 days after the initial trauma. During a mean follow up period of 20.5±5.2 (range 11 to 49) months, except for one case of phthisis, other eyes achieved acceptable anatomic and functional outcomes. Postoperative vision was NLP in two eyes (11.1%), light perception in three eyes (16.7%), hand motions in four eyes (22.2%), counting fingers in three eyes (16.7%) and 20/200 or better in six eyes (33.3%). CONCLUSION: Following eye trauma, NLP vision and RAPD of 3-4+ alone may not be an indication for enucleation. Performing exploratory surgery within 14 days after the injury may salvage the globe and improve vision; this approach may be more acceptable psychologically for patients and relatives.