[Pre-equatorial contusion syndrome. Analysis apropos of 59 cases]

The term "pre-equatorial syndrome" covers post-traumatic involvement of the anterior segment and of the pre-equatorial retina, due to a frontal distension mechanism. In a retrospective study, we studied 582 cases of ocular contusions from 1973 to 1986 in patients who required a brief hospitalisation in our clinic because of the severity of the initial injury. The aim of the study was to assess the occurrence of this syndrome, its clinical features and evolution. 59 complete pre-equatorial syndromes were found in this sample (10.2% of all the ocular contusions). The follow up ranged from one to 168 months. Games and sports injuries in children and work injuries in young men were most commonly found causes (2/3 of the cases). Hyphema and angle recession were the most frequently observed lesions (69%). All hyphemas disappeared spontaneously without surgical drainage. Subluxation of the lens was present in 10.6% and late post traumatic cataract occurred in four cases; all eyes were operated on by intracapsular extraction, three of them in the first year following the traumatism and the last twelve years latter. Intraocular pressure was high in 15.3% (but was easily controlled) and was very low in 5.1%. Retinal edema and haemorrhages were the most common involvement of the peripheral retina. Retinal dialysis was noticed in 13.6% especially in the upper nasal area: buckling surgery was performed in these cases with good results. Anterior and peripheral retinal damages was situated on the same meridian in 80% of the cases, five eyes showed a 180 degrees opposite setting while there was no obvious alignment in 15 of the cases. This syndrome did not impair final visual function alone, whereas severe associated ocular contusions of the posterior pole gave a very low visual outcome in 16 cases. This retrospective review emphasizes the main characteristics of this syndrome. Accurate examination of the irido-corneal angle and peripheral retina is of paramount importance in every ocular contusion.