Okuläre Verletzungen und Triage nach Bombenattentat auf die Botschaft der Vereinigten Staaten von Amerika in Nairobi (Kenia)123

Abstract

As a result of the terrorist bombings of the United States Embassies in Daressalam (Tansania) and Nairobi (Kenya) on August 7, 1998, over 200 people were killed. 5000 persons were injured severely. The purpose of this article is to provide a review of our experiences in the evaluation and treatment of patients with multiple simultaneous ocular injuries sustained in the Nairobi attack. We treated eight survivors of the assault, four of them with extremely severe eye injuries. A three-tiered system of triage developed. The first level occurred on scene, in which minor injuries were treated locally and more severe injuries were transported by aeromedical evacuation to Landstuhl Regional Medical Center (LMRC), in Germany among other locations. Surgical exploration of all patients arriving at LRMC was performed and surgical repair was undertaken when appropriate and technically possible. Patients requiring vitreoretinal surgery were transferred either to Saarland University Eye Hospital, Homburg, Germany, or Walter Reed Army Medical Center, Washington, DC. Only one eye required enucleation, due to an almost complete extrusion of the retina. It was possible to stabilize even severely injured eyes with multiple intraocular foreign bodies. Modern microsurgical techniques such as temporary keratoprothesis, perforating keratoplasty, and pars plana vitrectomy can now save eyes and often allow restoration of usuable visual acuity where this once have been deemed impossible.