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Sarah M Abbassi, Poonam Misra, Alain Bauza, Marco Zarbin, Neelakshi Bhagat; Demographics, Characteristics, Interventions, and Outcomes of Eyes with Open Globe Injuries with Intraocular Foreign Bodies. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3846.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the demographics, characteristics, interventions, and outcomes of eyes with open globe injuries (OGIs) with intraocular foreign bodies (IOFBs) that presented to University Hospital in Newark, NJ between 2004 and March 2013.
Sixty-five OGIs with IOFBs in 65 patients were identified of which 61 (93.8%) were male. The average patient age was 35.4 years (range 13-63). Thirty (46.2%) IOFBs were in the posterior segment (PS), 28 (43.1%) in the anterior segment (AS), and 4 (6.1%) in both AS and PS. Three eyes (4.6%) underwent primary enucleation. Hammering was the most common cause of injury accounting for 21 (33.9%) cases and metal was the most common IOFB accounting for 48 (77.4%) cases. The entry wound was located in zone I in 47 (75.8%) eyes. The majority of the wounds were limited to the cornea 42 (67.7%) cases. At presentation, 34 (54.8%) eyes had traumatic cataracts, 16 (25.8%) retinal detachment, 28 (45.2%) vitreous hemorrhage, 1 (1.61%) hemorrhagic choroidals, 15 (24.2%) hyphema, and 3 (4.84%) primary endophthalmitis. The mean Snellen visual acuity (VA) at presentation was 20/274, ranging from NLP to 20/20. The mean final VA for patients with a follow-up of ≥ 6 months was 20/188, ranging from LP to 20/20. All eyes underwent primary globe repair. Thirty eyes (100%) with PS IOFBs, and one (3.4%) with AS IOFB underwent simultaneous primary pars plana vitrectomy (PPV) with OG repair and IOFB removal. Sixty-one (98.4%) eyes were placed on IV antibiotics for a mean duration of administration of 3.75 and 3.90 days in AS and PS IOFBs respectively. Eight (12.9%) eyes received intravitreal antibiotics. Secondary surgical intervention was performed in 31 (50.0%) eyes and included PPVs (21), PPL (6), IOL placements (9), cataract extraction (7), and IOFB removal (5). Thirty-one (50.0%) eyes underwent cataract extraction; 24 at presentation of which 19 were left aphakic and 5 underwent IOL placement at a later date.
Open globe injuries with IOFBs may have a better visual outcome than penetrating or rupture type of open-globe injuries. In our current series, the Snellen VA was better than 20/200 in over half the cases with a follow-up of ≥ 6 months.
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