SURGICAL TREATMENT OF SEVERELY TRAUMATIZED EYES WITH NO LIGHT PERCEPTION EBADOLLAH HEIDARI, MD, NAZLI TAHERI, MD Purpose: The purpose of this study was to evaluate the anatomical and functional outcomes of surgical intervention in severely traumatized eyes with no light perception (NLP). Methods: In this prospective interventional case series, 18 eyes of 18 patients with severe ocular trauma whose vision was documented as NLP and with relative afferent pupillary defect of 3 to 4+ underwent deep vitrectomy and other appropriate procedures 1 to 3 times. Results: Vision was NLP in all eyes at the time of surgery, which was performed 3 days to 14 days after the initial trauma. During a mean follow-up period of 20.5  5.2 months (range, 11–36 months), except for 1 case of phthisis, other eyes achieved acceptable anatomical and functional outcomes. Postoperative vision was NLP in 2 eyes (11.1%), light perception in 3 eyes (16.7%), hand motions in 4 eyes (22.2%), counting fingers in 3 eyes (16.7%), and 20/200 or better in 6 eyes (33.4%). Conclusion: After eye trauma, NLP vision and relative afferent pupillary defect of 3 to 4+ alone may not be an indication for enucleation. Performing exploratory surgery within 14 days after the injury may salvage the globe and improve vision; this approach also entails positive psychologic effects for patients and relatives. RETINA 30:294 –299, 2010 O cular trauma is an important cause of visual loss worldwide. 1 In the United States, 2.5 million persons, particularly young individuals, sustain eye injuries each year, of whom 50,000 develop signifi- cant visual loss. 2 Mechanical trauma to the eye based on Birmingham Eye Trauma Terminology (BETT) and the Ocular Trauma Classification Group is subdi- vided into open- and closed-globe injuries. Types of open-globe injury are as follows: rupture, penetrating, intraocular foreign body (IOFB), perfo- rating, and mixed. Types of closed-globe injury are as follows: contu- sion, lamellar laceration, superficial foreign body, and mixed. 3 In an open-globe injury, the eye wall has a full- thickness wound, whereas there is no full-thickness wound in a closed-globe injury. 4 Ocular trauma may lead to various forms of damage to different parts of the eye, ranging from superficial abrasions to sight- threatening lesions. Improvements in our knowledge of the pathophys- iology and management of ocular trauma during the past 30 years together with advances in instrumenta- tion and techniques of ocular surgery have improved the efficacy of vitreoretinal surgery in injured eyes. Achieving or maintaining useful vision depends on several prognostic factors, such as severity of the initial trauma, involved ocular structures, preoperative visual acuity, and timely diagnosis and treatment. The outcomes of early surgical management in injured eyes with light perception (LP) vision have been re- ported with different success rates; however, no con- sensus exists on the surgical management of eyes with no LP (NLP). In this study, we describe the anatom- ical and functional outcomes of surgical intervention for traumatized eyes with NLP vision. Methods This prospective interventional case series includes 18 eyes of 18 patients with severe trauma, NLP vision, and relative afferent pupillary defect (RAPD) of 3 to From the Department of Ophthalmology, Nikookari Eye Hospi- tal, Tabriz Medical University, Tabriz, Iran. Reprint requests: Ebadollah Heidari, MD, Department of Oph- thalmology, Nikookari Eye Hospital, Tabriz Medical University, Nikookari Hospital-Abbasi Avenue, Tabriz 5154645395, Iran; e-mail: ebadolla_heidari@yahoo.com 294