Doctors perform complex surgery to save three construction workers from the brink of blindness

Pune: A team of doctors at a city eye hospital successfully performed complex corneo-scleral tear suturing (a surgical procedure performed under an operating microscope to close eye lacerations) on three construction workers who suffered severe ocular trauma. While the vision of two workers, who sustained injuries while working with iron nails, has been restored fully after the procedure, that of the third, who was injured by a grinding machine, will be restored in full after keratoplasty (corneal transplant), said Shilpa Joshi, head of the cornea department and eye bank director at HV Desai Eye Hospital.
The three, all in their early 20s and originally from North India, came to the hospital with their supervisor within an hour of the accidents. Joshi said that the injuries were particularly severe due to the high velocity of metal particles. "Small metal burrs can hit the eye at high speeds, causing devastating damage to the cornea. In these cases, all three workers suffered injuries to their right eyes," she said. Upon arrival, the three underwent slit-lamp examinations to assess the depth of the tears, followed by X-rays and CT scans to determine if metal fragments had penetrated the globe. They were immediately moved to the operating theatre for corneo-scleral tear suturing, a procedure that took approximately three hours on Dec 20. Snehal Ghadge, a cornea consultant at the hospital, described the procedure as a highly delicate repair of lacerations affecting both the cornea and the sclera (the white part of the eye). "The surgery requires precise tissue repositioning and ultra-fine sutures to restore the integrity of the eye, ensure a watertight closure, and minimise infection risks," she said. Ghadge added that experienced surgeons must also determine if secondary procedures, such as cataract surgery or keratoplasty (corneal transplant), are necessary. Cornea consultant Pooja Aandhare said, "Two patients are doing well as their injuries were peripheral and outside the visual axis. They will be monitored for infection, and sutures will be removed in 6–8 weeks. They may eventually require glasses or contact lenses." However, the third patient, who sustained a central corneal injury, may require a future keratoplasty to fully restore his sight, she said. Rahul Deshpande, chief medical director of HV Desai Eye Hospital, highlighted a recurring issue in booming cities like Pune. "There is a desperate need for better awareness regarding on-site eye safety. These are typically young, migrant workers from impoverished backgrounds. Most lack insurance or the necessary documentation to access state health benefits like the Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY)," he said. Joshi said eye trauma is an absolute emergency. "Patients must be brought to tertiary care hospitals immediately, as these cases often require a multidisciplinary approach for the best possible outcome," she said.