gms | German Medical Science

On June 07, 2003 a terrorist bomb attack occured in Kabul, blowing up a military bus with German soldiers on their way home. The explosion resulted in 30 casualties including four deaths. Eleven on these patients were evacuated to the tertiary medical center Ulm, nine of them with ocular injuries. We report the experience of our department in the evaluation and therapy of multiple simultaneous ocular trauma.

Nine patients who sustained ocular injuries as a result of terrorist bombing were evacuated to our facility and retrospectively evaluated. Each patient had a primary preoperative evaluation, some surgical intervention and follow up care for one day. All patients were classified by the Abbreviated Injury Scale (AIS). Three out of nine patients suffered from severe penetrating eye injuries.

One of the three eyes with severe penetrating lazeration and intraocular foreign body was enucleated six weeks after trauma. A main problem was seen in the plastic foreign bodies on external eye, melting in epithelial and stromal tissue by explosion heat. Superficial wounds of the eye and adnexa could be revised within one week. Two patients with Contusio bulbi recovered full vision.

Blast-injury patients need a fast and professional interdisziplinary team of surgeons. There is a high risk of open globe injury as a result of glass and plastic fragments from Autoside paneling. Very important for the fast success is the fast lead-in supply and antibiotic cover of the patients. A difficulty seems the melted plastic fragments, not to detect by CCT or ultrasonic. The types of injury of terrorist - blasts are mostly very extensive, involve all tissues of the eye and required care in a tertiary faciity with a clinical Head Center.