Rupture is the most severe type of injury;1 partially responsible for the poor prognosis is the instantaneous extrusion of tissues through the wound.2 Much of the damage occurs at the time of impact (Table 2.11.1) - this is the part of the damage the surgeon cannot influence; however, tissue incarceration and late scarring (Fig. 2.12.1) are significant threats, and here proper and timely intervention is able to positively impact the outcome. Eyes with posterior scleral extension fare much worse than eyes with only a limbal wound [1, 7], especially if primary or secondary retinal incarceration occurs (see Chap. 2.14).
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