Thomas A. Swift's Electric Rifle Injuries to the Eye and Ocular Adnexa: The Management of Complex Trauma

Stavros N Moysidis; Nicole Koulisis; Damien C Rodger; Jennifer R Chao; Theodore Leng; Talisa de Carlo; Bruce Burkemper; Lilangi S Ediriwickrema; Meena S George; Yi Jiang; Kelley J Bohm; Shilpa Gulati; Rodrigo J Torres; Mario A Meallet; Andrew A Moshfeghi; Harry W Flynn, Jr; William F Mieler; George A Williams; Mark S Humayun; Dean Eliott

doi:10.1016/j.oret.2018.10.005

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Thomas A. Swift's Electric Rifle Injuries to the Eye and Ocular Adnexa: The Management of Complex Trauma

Journal article

Peer reviewed

Thomas A. Swift's Electric Rifle Injuries to the Eye and Ocular Adnexa: The Management of Complex Trauma

Stavros N Moysidis, Nicole Koulisis, Damien C Rodger, Jennifer R Chao, Theodore Leng, Talisa de Carlo, Bruce Burkemper, Lilangi S Ediriwickrema, Meena S George, Yi Jiang, …

Ophthalmology retina, Vol.3(3), pp.258-269

2019-03

DOI: https://doi.org/10.1016/j.oret.2018.10.005

PMID: 31014704

Abstract

Humans

Middle Aged

Vitreoretinal Surgery

Male

Firearms

Electric Injuries - surgery

Eye Foreign Bodies - surgery

Young Adult

Adolescent

Eye Injuries, Penetrating - surgery

Adult

Vitrectomy

Retrospective Studies

Retina - injuries

To report the ocular and adnexal injuries sustained by patients with Thomas A. Swift's electric rifles (TASER; TASER International, Scottsdale, AZ), review the literature, and discuss the management of this complex trauma. Multicenter, retrospective case series and literature review. Seventeen eyes of 16 patients (5 eyes of 5 patients treated at 3 institutions, and 12 eyes of 11 previously reported cases). The clinical data of 17 eyes were pooled. Spearman's correlation coefficient was used to assess the association between the extent of TASER injury and patient outcomes. Extent of TASER injury (zone of injury, penetrating vs. perforating) and association with patient outcomes (visual acuity [VA] and retinal detachment [RD]). In our cohort, 4 patients were transported by law enforcement and 1 was transferred from a community hospital. Four patients were taken to the operating room for TASER removal and globe repair; 1 patient underwent removal in the emergency room. Of 17 pooled cases, 12 (71%) involved open-globe injury. Of these, there was a high rate of zone 3 injuries (100%; n = 12) and a high incidence of RD (73%; 8 of 11, eviscerated eye excluded). Among patients with closed-globe injury (n = 5), 1 patient demonstrated exudative RD and 1 patient demonstrated retinal dialysis with RD. Of 10 patients with RD, 1 (10%) achieved resolution with monitoring (exudative RD); 1 (10%) underwent cryopexy and pneumatic retinopexy; 3 (30%) underwent vitrectomy, and 5 (50%) with poor prognosis did not undergo vitreoretinal surgery. In the 3 patients who underwent vitrectomy, all 3 (100%) demonstrated redetachment resulting from proliferative vitreoretinopathy and required additional surgery. Visual acuity on presentation was significantly correlated with final VA (ρ = 0.783; P = 0.02). Men (94%) were more likely than women (6%) to sustain TASER trauma. Median age was 26 years. There was a 50% rate of loss to follow-up. Thomas A. Swift's electric rifle injuries to the eyes or ocular adnexa represent complex trauma. Zone 3 injuries are common. The visual prognosis is guarded, and eyes may require multiple surgeries to preserve vision. Patients are at high risk for loss to follow-up by way of incarceration.

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Title: Thomas A. Swift's Electric Rifle Injuries to the Eye and Ocular Adnexa: The Management of Complex Trauma
Creators: Stavros N Moysidis - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California; Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
Nicole Koulisis - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California
Damien C Rodger - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California
Jennifer R Chao - Department of Ophthalmology, University of Washington, Seattle, Washington
Theodore Leng - Byers Eye Institute at Stanford, Stanford University School of Medicine, Palo Alto, California
Talisa de Carlo - Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois, Chicago, Illinois
Bruce Burkemper - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California
Lilangi S Ediriwickrema - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California
Meena S George - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California
Yi Jiang - Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois, Chicago, Illinois
Kelley J Bohm - Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois, Chicago, Illinois
Shilpa Gulati - Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois, Chicago, Illinois
Rodrigo J Torres - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California
Mario A Meallet - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California
Andrew A Moshfeghi - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California
Harry W Flynn, Jr - Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
William F Mieler - Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois, Chicago, Illinois
George A Williams - Associated Retinal Consultants, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan
Mark S Humayun - USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology, Los Angeles County + University of Southern California Medical Center, Los Angeles County Medical Center, University of Southern California, Los Angeles, California; USC Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, California
Dean Eliott - Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts. Electronic address: dean_eliott@meei.harvard.edu
Publication Details: Ophthalmology retina, Vol.3(3), pp.258-269
Publisher: United States
Academic Unit: UMMG Department of Ophthalmology
Language: English
Resource Type: Journal article
PMID: 31014704
Record Identifier: 991031578737002976