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Azusa Fujikawa, Hirofumi Kinoshita, Makiko Matsumoto, Eiko Tsuiki, Kiyoshi Suzuma, Takashi Kitaoka; The visual outcome and prognostic factors in open globe ocular injuries. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6038.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate characteristics and prognostic factors in open globe ocular injuries.
Retrospective study of 59 eyes of 59 patients presented with open globe injuries between September 2008 and March 2014 at Nagasaki University Hospital was conducted. Demographic factors including age, gender, and clinical data such as cause of injury, presenting visual acuity (VA), location of injury, type of injury, lens status, presence of intraocular foreign body, types of required surgeries, and final VA were recorded. Prognostic factors were analyzed by comparing the characteristics of two groups: Light perception (LP) (range between LP-24/20) group and no light perception (NLP) group. According to the classification of Ocular Trauma Classification Group, wound location was classified into three zones. Chi-square test was used to compare presented data.
Fifty nine patients (46 LP group, 13 NLP group) were included in this study. The mean age was 56.7± 21.8 years in LP group and 62.3± 21.7 years in NLP group with no statistical difference (P=0.67). According to cause of injury, work-related trauma was the most common one (27 eyes) followed by falls (19eyes). Work-related trauma was significantly common in males (P=0.004), while falls was significantly common in females (P=0.00001). Zone 3 injuries were significantly common in NLP group (P=0.04). All cases of NLP group (100%) presented with rupture globe. Posterior segment intraocular foreign bodies were found in 12 eyes of all patients. Crystalline lens dislocation was found in 11 eyes (5LP, 6NLP with P=0.0003). Poor VA at first visit (P=0.00001), rupture globe (P=0.0026), history of penetrating keratoplasty (P=0.02), and dislocation of crystalline lens (P=0.0003) were considered as poor prognostic factors. Eyes first treated with Pars Plana Vitrectomy (PPV) were significantly more likely to achieve LP or better final vision (P=0.012).
Poor VA at first visit, rupture globe, zone 3 injuries, history of penetrating keratoplasty, and dislocation of crystalline lens were considered as poor prognostic factors. PPV had a good prognostic value in open globe injuries associated with posterior segment involvement.
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