PERFORATING BB GUN INJURIES OF THE GLOBE

BACKGROUND AND OBJECTIVE: To determine the visual and anatomic outcome s of eyes with perforating BE gun injuries. PATIENTS AND METHODS: The authors reviewed the surgical management and final visual outcome of s even patients with BE gun-related perforating injuries of the globe se en by them between 1980 and 1995. Six patients underwent surgery, and one patient refused intervention and was lost to follow-up. Scleral bu ckles, lensectomies, and vitrectomies were performed in these six case s. RESULTS: Five patients had a final visual acuity of 5/200 or better , with four patients achieving 20/200 or better and two of them having 20/70 or better. A posterior perforation involving the macula or an a rea temporal to the macula was associated with poor visual outcome. Th e visual acuity and the relative afferent pupillary defect at presenta tion or after the initial repair did not correlate with the final visu al outcome. In addition, the presence of subretinal blood did not nece ssarily portend a poor prognosis in these young patients. CONCLUSIONS: At least some eyes with perforating injuries can retain good visual a cuity with aggressive surgical management using modern vitrectomy tech niques. Visual acuity should not necessarily be used as the only exclu sion criterion for intervention or enucleation.