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Alain M. Bauza, Parisa Emami-naeini, Nishant G. Soni, Paul D. Langer, Marco A. Zarbin, Neelakshi Bhagat; Demographics and Outcomes of Vitreo-retinal Surgeries in Eyes with Assault- Related Open Globe Injuries. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4978.
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To describe the demographics and outcomes of assault-related open-globe (OG) injuries that underwent vitreoretinal surgery for posterior segment complications at the University Hospital (UH), Newark, New Jersey over a ten-year period.
The medical records of all eyes that presented to the University Hospital at Newark, NJ with an assault-related OG injury between January 1, 2001 through June 30, 2010 were retrospectively analyzed.
148 eyes of 147 patients with assault-related OG injuries were identified. Of these eyes, 50 (33.8%) underwent pars plana vitrectomy (PPV) for posterior segment complications. Forty-one eyes (82%) of the PPV group were male; 80 eyes (81.6%) of the non-PPV group were male. Initial LogMAR visual acuity (VA) of eyes that underwent PPV was 2.32 ± 1.2, and initial VA of eyes that did not undergo PPV was 2.41 ± 1.6. The initial VA of the two groups were not statistically different (P=0.5). Initial VA of NLP was seen in 9 of 50 eyes in PPV group (18%) and 48 of 98 eyes (49%) in the non-PPV group. Final VA of PPV group eyes was 1.85 ± 0.21; final VA of non-PPV group eyes was 2.46 ± 0.26. The final VA of the two groups were statistically different (P=0.002). Of the PPV eyes, only 2 (4%) had final VA of NLP; final VA of NLP was seen in 44 (46%) of the non-PPV eyes.The characteristics of eyes that underwent PPV following OG repair are described below. The anatomic site of the wound was zone 1 in 6 eyes (12%), zone 2 in 13 eyes (26%), zone 3 in 29 eyes (58%), and not documented in 3 eyes (4%). The types of OG injuries include 27 ruptures (54%), 18 penetration (36%), 0 perforations, and 1 mixed rupture/penetration injury (2%). Four eyes (8%) had intraocular foreign bodies (IOFB), including 2 glass and 2 metal. Seven eyes underwent PPV in initial repair (14%). Forty-three eyes underwent PPV in secondary surgeries. Indications for PPV included retinal detachment (RD), vitreous hemorrhage, hemorrhagic choroidals, IOFB removal, proliferative vitreoretinopathy, tractional RD, and suspected endophthalmitis. Thirty-seven eyes underwent PPV for RD; 2 of these eyes subsequently underwent enucleation.
One-third of assault-related OG injuries underwent PPV for posterior segment complications. Although the visual prognosis is poor in this group, PPV may potentially play an important role in improving functional outcomes.
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