Purpose
To evaluate visual outcome, anatomic outcome, and ocular survival in ruptured globe patients undergoing retinal surgery.
Methods
A retrospective chart review was performed to identify all ruptured globes during the period between 01/2007 - 12/2011 undergoing either primary or secondary retinal surgery with a minimal follow-up of 4 months. Information was obtained with regards to patient demographics, their injury (including type, zone, mechanism, wound size), surgery if applicable, and the visual and anatomic outcomes.
Results
There were 36 eyes necessitating retinal surgery out of 183 ruptured globes. Main indications for retinal surgery were IOFB, retinal detachment, non-clearing vitreous hemorrhage, and traumatic cataracts. Ocular survival was 71%. 8% of eyes underwent enucleation and 21% became phthisical. 45% were able to achieve ambulatory VA of CF or better and 15% were able to achieve reading VA of 20/40 or better. Negative predictors of ambulatory vision include: initial VA=NLP (p=0.0044), blunt trauma (p=0.05), and retinal detachment (p=0.0053). Wound size >10mm was a significant predictor of phthisis (p=0.0006). Eyes with retinal detachment and IOFB were more likely to be enucleated or become phthisical. Of the 8 eyes that had NLP vision at presentation, globe survival was 50%, and 33% had modest improvement of vision to HM-LP.
Conclusions
With modern vitreo-retinal techniques, a majority of eyes requiring retinal surgery after ruptured globe repair are saved and almost half of these eyes can obtain ambulatory vision. Negative predictors of vision and globe survival include large laceration, poor initial vision, blunt trauma and concurrent retinal detachment.
Keywords: 697 retinal detachment •
742 trauma •
762 vitreoretinal surgery