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Christiana Dinah, Philipp Baenninger, Oliver Baylis, Oliver Baylis, Andrew Browning, Francisco Figueiredo; Clinical Characteristics And Outcomes Of Open Globe Injuries Compared Over A 10 Year Period In A Tertiary Referral Centre In The UK. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4958.
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© ARVO (1962-2015); The Authors (2016-present)
To compare differences in demographics, clinical characteristics and outcomes of penetrating eye injuries in 2000 and 2010 in a tertiary eye emergency service in the UK
A retrospective medical records review was performed for two 12-month periods in 2000 and 2010
Eye theatre records review identified 17 patients in 2000 and 21 in 2010. Analysis was conducted on 10 (58%) and 16 (76%) patients, respectively due to unavailable records. 100% of penetrating eye injuries occurred in males in 2000 versus 75% in 2010. Mean age was 33.2 years (range 20-69) in 2000 versus 48.3 (range 6-84) in 2010 (p=0.014). Mean follow-up was 22.2 months and 9 months for 2000 and 2010, respectively. Clinical characteristics: The entrance wound was limited to the cornea in 7 eyes (70%) in 2000 and 5 eyes (31.25%) in 2010. The injury was limited to the anterior segment in approximately half the eyes in both cohorts, with a higher proportion of lens involvement in 2000 (50%) compared to 18.75% in 2010. A lower proportion of injuries with a blunt mechanism was observed in 2000 (10%) compared to 2010 (37.5%). Conversely, projectile injuries accounted for 60% of injuries in 2000 versus 6.25% in 2010 (p=0.004). In addition, a significant number of eye injury was associated with intraocular foreign body in 2000 (50%) in contrast to 6.25%, in 2010 (p=0.01). In both time periods, the type of injury classified by intent was mainly accidental (68.8% in 2000 versus 70% in 2010). There was a 60% increase in length of hospital stay in 2010 (5 days versus 3 days, p=0.012). Outcome: There was no observed difference in number of surgical intervention, with 50% of eyes having secondary intervention and approximately 30% requiring a third surgical intervention in both cohorts. Complication rates were similar in both cohorts. A lower proportion of eyes had poor vision (BCVA ≤ 6/18) at presentation in 2000 (60%) compared to 2010 (93.75%), p=0.034. BCVA improvement was similar at last follow-up with 60% of eyes demonstrating an improvement of ≥ 2 lines in 2000 compared to 62% in 2010. There was a lower proportion of eyes with poor vision (BCVA ≤ 6/18) at last follow-up in 2000 (30% versus 50%).
Our data demonstrates a significant increase in the proportion of eyes with poor vision at presentation (BCVA </= 6/18) in 2010. This is associated with longer hospital stay and may reflect the increased severity of open globe injuries secondary to blunt mechanisms. A significant reduction in projectile mechanism-related open globe injuries over the decade is observed, associated with a reduction in intraocular foreign body. Proportion of eyes with poor vision (BCVA </=6/18) at last follow-up remained higher in the 2010 cohort
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