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Natalie Wolkow, Eric D Gaier, Sami Tarabishy, Seanna R Grob, Daniel Lefebvre, Matthew Gardiner; Open globe injury associated with orbital fracture carries a poor prognosis. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5949.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular trauma, including open globe injury, carries a wide range of clinical severity and visual outcomes. Orbital fractures can co-occur with open globe injuries, more commonly in the setting of blunt trauma. Few studies have examined outcomes of patients with open globe injuries and concomitant orbital fractures. We hypothesized that open globe injuries with concomitant orbital fractures carry a relatively poor prognosis.
We retrospectively reviewed the medical records of 75 patients with concomitant open globe injuries and orbital fractures, identified by ICD9 coding between 2007 and 2015. We extracted data concerning the, presentation, clinical and radiographic features, subsequent surgeries and final documented visual outcome for each patient. Globe Zones were defined as follows: I cornea, II limbus-5mm posterior to the limbus, III posterior to Zone II.
Fifty-four men(73%) and 20 women(26%) were included in this study. The average age at presentation was 45±25 years. Zonal globe involvement was 32(44%), 50(68%) and 51(70%) patients for Zones I, II and III, respectively. Sixty-seven patients(92%) had uveal prolapse. Seventy-two patients(96%) had primary open globe closure surgery, and 25(33%) went on to have subsequent retinal surgery. Thirteen patients(17%) had their orbital fractures repaired. Sixteen patients(23%) had enucleation/evisceration surgery, 3 of which were the primary surgical procedure after presentation. Of the 55 patients who still had their eye at their last follow up, only 16(29%) had counting fingers vision or better.
Our data support our hypothesis that open globe injuries that present with concomitant orbital floor fractures carry a relatively poor visual prognosis. Our data suggest that this category of open globe patients should be counseled with guarded expectations.
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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