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. 2013 Dec 31;44(4):218-23.
eCollection 2013 Oct.

Ocular trauma from land mines among soldiers treated at a University Hospital in Medellín, Colombia

Liliana Moreno  1 , Luis F Velasquez  1 , Carlos A Restrepo  1 , Jose D Paulo  1 , Jorge Donado  2 , Marta L Muñoz  1 , John J Aristizabal  1
Affiliations

Ocular trauma from land mines among soldiers treated at a University Hospital in Medellín, Colombia

Liliana Moreno et al. Colomb Med (Cali). .

Abstract
in English, Spanish

Introduction: Currently ocular combat injuries are complex and associated with poor visual outcomes. Our objective is to characterize the military population that suffer land mine combat ocular trauma in Colombia and identify the type of wound, treatment and visual outcomes.

Methods: Retrospectively review of medical history of soldiers evaluated in Pablo Tobon Uribe Hospital, whom had land mine trauma during January of 2004 and December 2012.

Results: 635 soldiers had land mine trauma, 153 of them had ocular trauma (226 eyes). Open ocular trauma was observed in 29.6%. The Ocular Trauma Score was calculated in 183 eyes, the initial visual acuity was not possible to be reported in the rest of them; the 45% of the eyes were classified in category 3. Three patients had no light perception in both eyes. 97.3% of the eyes received medical treatment and 49.1% had surgery also. Primary evisceration was made in 5.8% and enucleation in 1.8%. Intraocular foreign body was observed by ultrasonography in 11.1% and in 5.8% by orbital tomography. Eleven patients were legally blind at discharge.

Conclusions: The ocular trauma related to a land mine is highly destructive at an ocular level. The treatments associated with better visual outcomes are primary closure of globe and systemic antibiotics; although the characteristics of the wound itself are the main prognostic factor. The Ocular trauma score is a useful tool for determining visual outcome in combat ocular trauma.

Introducción: Los combates armados generan heridas oculares complejas con mal pronóstico visual. Nuestro objetivo es caracterizar la población militar que sufre trauma ocular de combate en Colombia asociado a minas antipersona, así como las características de las lesiones, el tratamiento recibido y desenlace visual final.

Métodos: Se evaluó retrospectivamente las historias clínicas de soldados atendidos en el Hospital Pablo Tobon Uribe, que sufrieron accidente por mina antipersona durante el período entre enero de 2004 y diciembre de 2012.

Resultados: 635 soldados, sufrieron trauma por mina antipersona; de estos, 153 (226 ojos) tuvieron trauma ocular. El 29.6% tuvieron trauma abierto. Se calculó el Ocular Trauma Score en 183 ojos. El 45% de los ojos se clasificaron como categoría 3. Tres pacientes tuvieron una visión final de no percepción de luz por ambos ojos. El 97.3% de los ojos tuvieron tratamiento farmacológico y 49.1% recibieron cirugía además. Se realizó evisceración primaria en el 5.8% y enucleación en 1.8%. Se logró comprobar cuerpo extraño intraocular por ecografía en el 11.1% y por tomografía de órbitas en el 5.8%. Once pacientes fueron legalmente ciegos, al momento de abandonar el hospital.

Conclusiones: Las principales medidas terapéuticas asociadas con mejoría del pronóstico visual son el cierre primario de herida y la administración de antibióticos; aunque las características de las heridas oculares son el principal factor pronóstico. El Ocular Trauma Score es una herramienta útil para determinar el pronóstico visual en trauma ocular de combate.

Keywords: Eye injuries; eye foreign bodies; penetrating ocular injuries; trauma severity index.

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Conflict of interest statement

Conflicts of interest: There are none to declare.

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