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Controversies in the Management of Posterior Segment Open-Globe Injuries

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Albert and Jakobiec's Principles and Practice of Ophthalmology

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Abstract

This chapter thoroughly reviews controversies in the management of posterior segment open-globe injuries (OGI). The scope of the problem, mechanisms of injury, clinical features and findings, evaluation techniques, management options, complications, and visual and anatomic outcomes are reviewed, along with means of protection and prevention. Management of these injuries and visual prognosis depend on a variety of factors including visual acuity at presentation, mechanism of the injury, type of entrance wound and location, and the overall extent of ocular damage. Advances in surgical techniques, a better understanding of the pathophysiology of trauma, and improved management decisions are continuously evolving. The main areas of controversy center around the timing of surgery, placement of prophylactic cryotherapy and/or a scleral buckle, management of intraocular foreign bodies (IOFBs), use and selection of tamponade agents including silicone oil, use of prophylactic antibiotics, concurrent placement of primary IOLs, and management of postoperative or post-traumatic hypotony. Advances in surgical techniques, a better understanding of the pathophysiology of trauma, and improved management decisions are continuously evolving. Over the past several decades, the visual prognosis for patients with ocular injuries has significantly improved. Many aspects of the surgical care, however, remain controversial, and therefore, a careful review of the published data is critical before deciding how best to proceed with evaluation and treatment of a given case. The controversies discussed in this chapter remain a very significant public health care issue, and most likely will never be fully addressed or answered in controlled clinical trials. Management will be determined by consensus opinion and the best available data.

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  1. University of Illinois at Chicago, Chicago, IL, USA

    Talisa de Carlo & William F. Mieler

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  1. Talisa de Carlo
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  2. William F. Mieler
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Correspondence to William F. Mieler .

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Editors and Affiliations

  1. Department of Ophthalmology, Oregon Health & Science University Department of Ophthalmology, Portland, OR, USA

    Daniel Albert

  2. Massachusetts Eye and Ear, Boston, MA, USA

    Joan Miller

  3. Department of Ophthalmology, University of Illinois at Chicago Department of Ophthalmology, Chicago, IL, USA

    Dimitri Azar

  4. Department of Ophthalmology, Harvard Medical School, Boston, MA, USA

    Lucy H. Young

Section Editor information

  1. Massachusetts Eye and Ear, Boston, USA

    Dean Eliott

  2. Associate Professor of Ophthalmology, Harvard Medical School, Boston, USA

    Demetrios Vavvas

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de Carlo, T., Mieler, W.F. (2022). Controversies in the Management of Posterior Segment Open-Globe Injuries. In: Albert, D., Miller, J., Azar, D., Young, L.H. (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-90495-5_108-2

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  • DOI: https://doi.org/10.1007/978-3-319-90495-5_108-2

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  1. Latest

    Controversies in the Management of Posterior Segment Open-Globe Injuries
    Published:
    24 September 2021

    DOI: https://doi.org/10.1007/978-3-319-90495-5_108-2

  2. Original

    Controversies in the Management of Posterior Segment Open-Globe Injuries
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    27 August 2021

    DOI: https://doi.org/10.1007/978-3-319-90495-5_108-1

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