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Ananya Anne, Alain Bauza, Paul Langer, Roger Turbin, Marco Zarbin, Neelakshi Bhagat; Enucleation following Open Globe Injury. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4441.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the demographics, characteristics and outcomes of eyes with traumatic open globe injuries that underwent enucleations at University Hospital (UH), Newark, New Jersey over a ten-year period.
The medical records of all traumatic OGIs that underwent enucleations from 2001- 2010 were reviewed.
94 eyes of 93 patients with open globe injury underwent enucleations at UH in the defined 10- year time period. Seventy-six percent of patients were male and the mean age was 40.8 years. The most common cause of open globe injury was assault for 36 patients (38.7%), followed by blunt trauma due to an accidental fall for 16 patients (66.7%).The most common type of injury noted was rupture for 62 patients (66.7%), followed by penetrating injury for 21 patients (22.6%). The predominant anatomic site of the open globe wound was zone 3 in 55 patients (59.1%). Primary enucleations were performed in 21 (22.6%) of 94 enucleations for severely injured, non-salvageable eyes. All eyes that underwent primary enucleations were NLP at presentation. Mean length of time between primary globe repair and secondary enucleation was 41.3 days. Three patients (.03%) were enucleated for blind, endophthalmic eyes. Medpore implants were used in 86 enucleated eyes (92.5%); 62 eyes (72%) were fitted with 20 mm medpore balls. Complete post-operative records were available only for 44 of the 93 patients who underwent enucleations; 16(36%) of 44 eyes eyes noted to post-enucleation complications. The most common complaint after enucleation was periorbital pain within the first month (5 patients). Five patients (11.4%) complained of a mucoid discharge between 1 and 7 years post surgery. Only 2 eyes (4.5%) had extrusions of their implants, at 1 week and 1 year post-enucleation, respectively; only one of these underwent replacement of the implant.
Out of the 604 patients admitted to the UH with open globe injuries, 15.4% underwent enucleations. Those with zone 3 injuries are more likely to undergo primary enucleations (90.4%) than secondary enucleations (61.2%). Post-enucleation complications were low with only a 4.5% rate of implant extrusion.
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