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, William F. Mieler, George A. Williams, Mark S. Humayun, Dean Eliott

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Purpose: 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. Design: Multicenter, retrospective case series and literature review. Participants: Seventeen eyes of 16 patients (5 eyes of 5 patients treated at 3 institutions, and 12 eyes of 11 previously reported cases). Methods: 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. Main Outcome Measures: Extent of TASER injury (zone of injury, penetrating vs. perforating) and association with patient outcomes (visual acuity [VA] and retinal detachment [RD]). Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)258-269
Number of pages12
JournalOphthalmology Retina
Volume3
Issue number3
DOIs
StatePublished - Mar 1 2019

ASJC Scopus subject areas

  • Ophthalmology

Fingerprint Dive into the research topics of 'Thomas A. Swift's Electric Rifle Injuries to the Eye and Ocular Adnexa: The Management of Complex Trauma'. Together they form a unique fingerprint.

  • Cite this

    Moysidis, S. N., Koulisis, N., Rodger, D. C., Chao, J. R., Leng, T., de Carlo, T., Burkemper, B., Ediriwickrema, L. S., George, M. S., Jiang, Y., Bohm, K. J., Gulati, S., Torres, R. J., Meallet, M. A., Moshfeghi, A. A., Flynn, H. W., Mieler, W. F., Williams, G. A., Humayun, M. S., & Eliott, D. (2019). Thomas A. Swift's Electric Rifle Injuries to the Eye and Ocular Adnexa: The Management of Complex Trauma. Ophthalmology Retina, 3(3), 258-269. https://doi.org/10.1016/j.oret.2018.10.005