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S. Kohanim, M. T. Andreoli, C. M. Andreoli, A. V. Turalba; Open Globe Injuries in Women: Epidemiology, Risk Factors, and Outcomes. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5323.
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Open globe injuries represent a rare yet important clinical entity. There have been very few studies that have examined this entity in women. We set out to better characterize the epidemiology, risk factors and clinical outcomes of open globe injuries in women.
The hospital records of 811 patients with open globe injuries who presented to The Massachusetts Eye and Ear Infirmary from June 1999 to September 2008 were reviewed. Analysis was performed to assess epidemiology, nature and extent of injuries, details of primary and subsequent surgical procedures, as well as the final visual outcome.
175 of the patients studied (21.6%) were female. The average age of female patients was 57.01 years (range 0.74 to 95.45 years) vs. 36.4 years for males (p<0.001). In women, falls accounted for the majority of injuries (46.9%) followed by other blunt trauma (14.7%). Most of the injuries occurred at home (44.57%). In contrast, the most common setting for injuries in men was at work (22.4%) with a trend favoring projectile injuries, sports-related injuries, or sharp objects as etiologic factors. In women, the cornea was involved in over one-third of the injuries (34.65%). Preoperative visual acuity ranged from 20/15 to NLP with only 9 patients presenting with visual acuity of 20/40 or better. On presentation, an APD was present in 40 patients, hyphema in 80 patients, and vitreous hemorrhage in 55 patients. Post-operatively, only 25% of eyes achieved a visual acuity of 20/40 or better on any follow up visit. A statistically significant difference was found when compared to visual outcomes in men, where 43.7% obtained a visual acuity of 20/40 or better (P<0.001). The most common late complications were pthisis/prepthisis (8%), glaucoma (5.6%), and retinal scarring (4.5%). One patient developed sympathetic ophthalmia and 10 eyes (5.7%) were enucleated. There were no female patients with post-operative endophthalmitis.
There are significant differences between baseline characteristics and the mechanism of injury of open globe injuries between men and women. Prognosis after an open globe injury in women is strongly influenced by the nature of the injury. The extent of the initial damage and visual outcomes appears to be worse in women than in men.
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