Abstract
Purpose: :
To evaluate the factors influencing final vision outcome after surgical repair of open globe injuries and to validate the Ocular trauma score.
Methods: :
This retrospective non randomized observational case series was carried out at a tertiary referral eye care centre in Singapore over ten years from January 2000 till December 2009. Case records of 172 patients (age range between 15 yrs to 91 yrs) with open globe injuries were analyzed. Preoperative variables were correlated with the final vision outcome. Using statistical tests, the prognostic factors for vision outcome following surgical repair of open globe injuries were studied and Ocular trauma score was validated based on the results.
Results: :
Case records of 172 eyes with open globe injury were analyzed. Mean age was 36. 67 yrs. Mean follow up was 12.26 months. Males were predominantly affected. Initial visual acuity was 6/6 to 6/12, 6/15 to 6/60, 6/120 to CF@3ft, CFCF- PL and NLP in 24 (14%), 39 (22.7%), 16 (9.3%), 66 (38.4%) and 27 (15.7%) eyes respectively. Based on the Fischer’s exact test of independence mode of injury, visual axis involvement, lens status, hyphaema, relative afferent pupillary defect, vitreous loss, vitreous hemorrhage and retinal detachment were found to be statistically significant with the final vision outcome. Preoperative visual acuity and zone of injury were found to be statistically significant on correlation analysis. Final visual acuity was 6/6 to 6/12, 6/15 to 6/60, 6/120 to CF@3ft, CFCF- PL and NLP in 76 (44.2%), 28 (16.3%), 11 (6.4%), 30 (17.4%) and 27 (15.7%) eyes respectively. Validation of Ocular trauma score was carried out in the present study.
Conclusions: :
The present study showed preoperative variables such as mode of injury, preoperative visual acuity, traumatic cataract, hyphaema, relative afferent papillary defect, vitreous loss, vitreous hemorrhage were found to be adversely affecting the final vision outcome. Recognizing these factors prior to surgical intervention or intraoperatively can help the surgeon in evidence based counseling of the trauma victim and family of possible final vision outcome.
Keywords: trauma • clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: outcomes/complications