[Concise review of progress in the management of perforating injury (author's transl)]

Improvement in the management of perforating injuries has become possible since the successful control of infection. However, the decisive step ahead was accurate suturing. The use of finer needles and of thinner, standardised suture material enabled accurate adaption of the margins and closer suturing. The anterior chamber could now be filled with air, thus preventing contact between iris and cornea. Development of new instruments enabled simultaneous management of haemorrhages and of injuries of the lens and vitreous body. Prolapse of iris without essential damage to the iris could be reduced either by limbal puncture or by intensive rinsing with fluid, proceeding from the edges of the wound. Parallel to the successful management of lens injuries a more radical form of vitreous surgery developed without significantly increasing surgical trauma. In Birmingham, during 1950--1958 45% of the patients with perforating injury of the anterior segment--including injury of the lens or iris--achieved a visual acuity of 6/12 or better. During 1971--1974 the corresponding percentage was 62% at the same clinic.