Purchase this article with an account.
Iris Sheng, Alain Bauza, Paul Langer, Marco Zarbin, Neelakshi Bhagat; A Ten Year Review of Open Globe Trauma in Elderly Patients at an Urban Hospital. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4432.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate the demographics, characteristics, and outcomes of open globe injuries (OGI) in elderly patients.
Retrospective chart review
Of the 90 cases, 36 (40 %) were male. The average age was 80.0 years (SD 8.23; range of 65-96 years). The types of OGIs included rupture (83.3%) and penetrating (16.7%) injuries. The causes of trauma were falls (64.4 %), accidental trauma (20%), motor vehicle accidents (5.5%) and assault (3.33%). Of these 90 eyes, 35 (38.9%) were in OTS category of 1, 15 (16.7%) in OTS category of 2 and 2 (2.22%) in OTS category of 3. The majority of lacerations were corneal (44.4%), followed by corneoscleral (26.7%), and then scleral (28.9%). Forty- one (45.6%) cases presented with pseudophakia, 26 (28.9%) with aphakia and 21 (23.3%) with phakic lens. Forty cases were OGIs with dehiscence of previous ocular surgical wounds. Ten eyes had concurrent orbital fractures. All cases underwent primary OGI repair within 24 hours of admission. Sixty-five (72.2%) patients spent 1-5 days in the hospital and 15 (16.7%) patients spent 6-10 days. The average visual acuity, in logMAR, at presentation was 2.37 (SD .638); at 3 months was 2.07 (SD .760), at 6 months was 2.04 (SD .890), and at 1 year was 1.66 (SD .997). While 22 patients presented with no light perception (NLP), only 10 remained NLP after OGI repair. Complications at presentation included: uveal prolapse (70%), hyphema (66.7%), chemosis (20%), hemorrhagic choroidals (37.8%), vitreous hemorrhage (VH) (51.1%), and retinal detatchment (RD) (20%) and afferent pupillary defect (42.2%). Four patients (4.44%) underwent primary pars plana vitrectomy (PPV) for RD and VH and 1 (1.11%) patient underwent primary PPV for endophthalmitis. Overall, retinal attachment was achieved in 3 of 5 eyes (60%) that underwent primary PPV. Secondary PPV was performed in 16 eyes: 14 for RD, 1 for suspicious RD and 1 for dislocated IOL. Retinal attachment was achieved in 13 of 16 eyes that underwent secondary PPV (81.3%). Primary enucleations were performed in 4 (4.44%) cases for non- salvageable, NLP eyes. Thirty-one patients underwent reoperations, which included 9 secondary enucleations.
The visual prognosis in open globe injury in elderly population is poor; only 14.4 % achieved 20/200 or better VA. Precautionary measures should be taken to prevent falls in the elderly population.
This PDF is available to Subscribers Only