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Paramdeep S. Mand, Bryan Kim, Gurunadh A. Vemulakonda; Retinal Detachments After Open-Globe Trauma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4969.
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Open globe injury often results in severe ocular injury and frequently requires vitreoretinal intervention. A common indication for intervention is retinal detachment. We examined patients who suffered retinal detachments after open globe trauma.
Retrospective chart-review of all patients with open globe injuries from January 2005 to October 2009 at a tertiary care center were analyzed. Inclusion criteria were all patients with open globes due to mechanical trauma. Exclusion criteria were patients with primary enucleation, patients with NLP vision after initial repair, and patients with less than 6 months of follow-up after initial repair, unless follow-up was truncated by enucleation in a patient who developed a retinal detachment. Significance for univariate analysis was set at p <0.003 when correcting with the Bonferroni method. Significance for multivariate analysis was set at p <0.05.Records were reviewed to obtain clinical and surgical outcome data. Associations between presenting signs and characteristics and incidence of retinal detachment were analyzed. Open globe injuries were classified using the Birmingham Eye Trauma Terminology.
There were a total of 171 open globes that were included in analysis, of which 69 eyes (40% suffered experienced retinal detachments after open globe trauma. Visual acuity after primary repair and prior to VR surgery ranged from 20/20 to LP. Visual acuity after VR surgery ranged from 20/20 to NLP. 4 patients (6%) had retinal detachments at presentation. There were 3 enucleations in this sample. Ten eyes resulted with NLP vision either after initial repair or at the time of final follow-up. Variables found to be significantly associated with retinal detachment in univariate analysis were presence of an APD (p<0.0001), presence of vitreous hemorrhage (p<0.0001), vitreous loss (p=0.003), and and scleral 3 region injury involvement (p=0.003). When performing multivariate analysis, only APD (p=0.049) and vitreous loss (p=0.047) were found to be associated with retinal detachment.
This study indicates that the presence of APD and vitreous loss in an open globe injury are statistically significant and clinically important signs for the presence or later development of retinal detachment.
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