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Clinical features of patients who underwent primary repair for anterior segment perforating injury under local anesthesia

Poster Details

First Author: S.Kivanc TURKEY

Co Author(s):    B. Akova-Budak   C. Cibik   A. Ozmen              

Abstract Details

Purpose:

To present clinical findings and wound characteristics of patients with open globe injuries involving anterior segment who underwent primary repair under local anesthesia.

Setting:

Uludag University, Department of Ophthalmology, Bursa, Turkey

Methods:

The medical records of 33 patients who underwent primary repair of anterior segment under local anesthesia between 2010 January and 2017 February were reviewed. The mean follow up was 10.6 �Â�±13.2 months. Of 33 patients, 27 had zone 1, 5 had zone 2 and 1 had all zones injury.Nine patients (27 %) had iris prolapsus, 10 had (30 %) vitreus prolapsus and 13 (39 %) had traumatic cataract. The median wound length was 2mm ( 0.5-30 mm). Iris prolapsus was noted in 18 % of corneal perforation, 33 % of scleral and 60 % of limbal injury.

Results:

IThe mean wound length was 1.9�Â�±1.5 mm in corneal perforations without iris prolapsus, whereas it is 4.2�Â�±2.5 mm with iris prolapsus. The mean wound length was 3.2�Â�±3.9 mm in limbal injuries without iris prolapsus and was 8.7 �Â�±5.5 mm with iris prolapsus.The difference was statistically significant for both corneal and limbal wounds ( p=0.035 and p=0.037). While there was no iris prolapsus with the wounds less than 2 mm, 43 % of the wounds more than 2mm had iris prolapsus ( P=0.012). Sedoanalgesia was used in 66 % of patients who had limbal wounds with iris prolapsus

Conclusions:

As iris tissue manipulation elicits pain, general anesthesia should be the choice of anesthesia in patients with open globe injuries involving anterior segment. However, local anesthesia may be used comfortably in corneal wounds less than 2 mm without iris prolapsus if general anesthesia is not available. If the wound involve limbus, sedoanalgesia should be provided at least for performing the surgery safely and comfortably.

Financial Disclosure:

NONE

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