Surgical Treatment of Severely Traumatized Eyes with No Light Perception

Purpose: To evaluate the anatomical and functional outcomes of surgical intervention inseverely traumatized eyes with no light perception (NLP).Methods: In this prospective interventional case series, 18 eyes of 18 patients withsevere ocular trauma whose vision was documented as NLP and with relative afferentpupi-llary defect (RAPD) of 3-4+ underwent deep vitrectomy and other necessaryprocedures once to three times.Results: Vision was NLP in all eyes at the time of surgery which was performed3-14 days after the initial trauma. During a mean follow up period of 20.5±5.2 (range 11to 49) months, except for one case of phthisis, other eyes achieved acceptable anatomicand functional outcomes. Postoperative vision was NLP in two eyes (11.1%), lightperception in three eyes (16.7%), hand motions in four eyes (22.2%), counting fingers inthree 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 anindication for enucleation. Performing exploratory surgery within 14 days after theinjury may salvage the globe and improve vision; this approach may be more acceptablepsychologically for patients and relatives.