Functional and anatomical outcome in closed globe combat ocular injuries

Objective: To analyse the pattern, visual and anatomical outcome of closed globe combat-related ocular injuries sustained by troops. Methods: This retrospective study was conducted at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan, and comprised patients with ocular injuries from January 2010 to June 2014. Record of each patient was evaluated and demography, mode and type of injury, initial and final visual acuity, associated globe injuries, concomitant non-ocular injuries, type of surgical procedures and complications were endorsed on a pre-devised proforma. Statistical analysis was done using SPSS 13. Results: Overall, 49 eyes of 44 male participants were analysed. The overall mean age was 27.59 +/- 6.89 years. The most common mode of injury was improvised explosive device blast responsible for 22(50%) casualties. Ocular contusion was the most frequent closed-globe injury occurring in 35(71.42%) eyes. Most frequent ocular findings in all injured eyes were vitreous haemorrhage 16(32.65%), cataract 12(24.48%), retinal detachment 8(16.32%) and commotio retinae 8(16.32%). A total of 48(97.96%) intra-ocular/adnexal surgeries were performed with pars plana vitrectomy 17(34.69%), cataract surgery 16(32.65%), intraocular lens implantation 8(16.32%), and adnexal surgery 5(10.20%) being the most frequently performed procedures. Overall visual improvement at the final follow-up was statistically significant in all injured eyes irrespective of mode of treatment (p = 0.001). Conclusion: The functional and anatomical outcome was better in closed-globe combat ocular injuries compared to open-globe injuries.