Abstract
Purpose: :
To review the mechanisms of injury and outcomes in adults who had open globe repair (OGR) with primary lensectomy.
Methods: :
Retrospective chart review of consecutive adult patients who underwent OGR with primary lensectomy at a tertiary eye hospital from January 1, 1999 to September 30, 2008. Analysis included comparison of initial and final visual acuity (VA), and mechanism and nature of injury. Exclusion criteria included follow-up data less than 3 months and age younger than 18 years.
Results: :
Of the 366 consecutive adult patients who underwent OGR and had 3 month follow-up data, 87 cases required primary lensectomy. The follow-up period ranged from 90 to 2,681 days (mean 501). Most patients were male (89.7%). Patient age ranged from 18 to 88 years (mean age 43 years). The majority of patients (64.4%) sustained corneal lacerations, while 10.7% had scleral involvement. The mechanism of injury was projectile in 51.7% of cases, and 23.0% of injuries occurred in the workplace. Post-operative complications included: glaucoma (18.7%), hyphema (23.0%), retinal detachment (23.0%), and one case of endophthalmitis (1.1%). Pre-operative VA was worse than 20/400 in 77% of cases and only 20/40 or better in 6.9%. Final best corrected VA (BCVA) of 20/40 or better was achieved in 41.4% of patients. In comparison, 47.3% of all adult OGR cases (n=366) had a final BCVA of 20/40 or better (p>0.05).
Conclusions: :
As expected, the majority of OGR with primary lensectomy involved injury to the cornea. Half of these injuries were caused by projectiles, underscoring the need for eye protection especially in the workplace. Final visual outcomes for OGR with primary lensectomy are surprisingly good and were not statistically different when compared to the entire group of OGR.
Keywords: trauma • cataract • clinical (human) or epidemiologic studies: outcomes/complications