June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Visual, surgical, and anatomic outcomes of consecutive open-globe injuries: a ten-year experience at a single institution
Author Affiliations & Notes
  • Jason Zhang
    Ophthalmology, Yale New Haven Hospital, Hamden, Connecticut, United States
  • Shaheen Kavoussi
    Ophthalmology, Yale New Haven Hospital, Hamden, Connecticut, United States
  • Tarek Alasil
    Ophthalmology, Yale New Haven Hospital, Hamden, Connecticut, United States
  • Seth Meskin
    Ophthalmology, Yale New Haven Hospital, Hamden, Connecticut, United States
  • Ron A Adelman
    Ophthalmology, Yale New Haven Hospital, Hamden, Connecticut, United States
  • Footnotes
    Commercial Relationships   Jason Zhang, None; Shaheen Kavoussi, None; Tarek Alasil, None; Seth Meskin, None; Ron Adelman, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 5510. doi:
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      Jason Zhang, Shaheen Kavoussi, Tarek Alasil, Seth Meskin, Ron A Adelman; Visual, surgical, and anatomic outcomes of consecutive open-globe injuries: a ten-year experience at a single institution. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5510.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To analyze visual, surgical, and anatomic outcomes of open globe injuries (OGIs).

Methods : Of 349 consecutive patients who presented to Yale-New Haven Hospital with OGI between 2003 and 2013, charts of 206 consecutive patients with at least 6 months of follow-up were reviewed. Multivariate statistical analysis was used to identify predictors of visual outcome, number of surgical interventions required, and anatomic outcome (salvaged globe, phthisis, or enucleation).

Results : Gender was male in 72% of cases. Age (mean ± SD) was 43.5 ± 24.46 (Range 1-94). Final follow-up (mean ± SD) was 28.02 months +/- 23.27 (range 6-108). Multivariate analysis demonstrated decreased likelihood of final BCVA ≥20/40 in patients with retinal detachment (initial or delayed, odds ratio (OR)=0.064, p<0.0001), decreased likelihood of final BCVA ≥20/400 in patients with RAPD (OR=0.031, p=0.0024) or subsequent PVR (OR=0.028, p=0.0015), increased likelihood of NLP outcome with initial NLP (OR=13.693, p=0.0011) and RAPD (OR=22.882, p=0.0001), increased likelihood of phthisis with initial RAPD (OR=24.860, p=0.0060) and subsequent PVR (OR=18.892, p=0.0125), increased likelihood of enucleation with initial RAPD (OR=26.476, p=0.0040), and increased likelihood of multiple surgical interventions with age >65 (OR=11.180, p=0.0042), 360° subconjunctival hemorrhage (OR=9.735, p=0.0084), lens injury (OR=26.405, p<0.0001), endophthalmitis (OR=145.468, p=0.0190), and retinal detachment (initial or delayed, OR=4.661, p=0.0213).

Conclusions : Retinal detachment, PVR, and RAPD are prognostic for poor visual and anatomic outcome after OGI. Age at presentation, 360° subconjunctival hemorrhage, lens injury, retinal detachment, ocular trauma score and endophthalmitis are surgical prognostic indicators. PVR and RAPD are important predictors of phthisis.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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