April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Traumatic Open Globe Injuries; A 5 Year Retrospective Review
Author Affiliations & Notes
  • A. M. Bauza
    UMDNJ - New Jersey Medical School, Newark, New Jersey
  • J. Son
    UMDNJ - New Jersey Medical School, Newark, New Jersey
  • S. N. Patel
    UMDNJ - New Jersey Medical School, Newark, New Jersey
  • M. A. Zarbin
    Ophthalmology & Visual Science, UMDNJ-New Jersey Medical School, Newark, New Jersey
  • N. Bhagat
    Ophthalmology, IOVS-New Jersey Med School, Newark, New Jersey
  • Footnotes
    Commercial Relationships  A.M. Bauza, None; J. Son, None; S.N. Patel, None; M.A. Zarbin, None; N. Bhagat, None.
  • Footnotes
    Support  RPB; Lions Eye Research Foundation of NJ
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 5376. doi:
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      A. M. Bauza, J. Son, S. N. Patel, M. A. Zarbin, N. Bhagat; Traumatic Open Globe Injuries; A 5 Year Retrospective Review. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5376.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate demographics, characteristics, and functional and anatomic outcome of patients with traumatic open globe injuries to University Hospital, Newark, NJ from 2005 to May 2009.

Methods: : Retrospective case series.

Results: : 284 patients (285 eyes) with open globe trauma were identified. There were 211 (74%) males and 74 (26%) females. The mean age was 38 years (range, 1-96,). Ocular injury type was rupture 114 (40%), penetration 159 (55.8%), perforation 10 (1.5%), and not documented 2 (0.7%). 30 (10.5%) eyes had IOFB. The rupture or laceration was noted in zone 1 (Z1) in 134 eyes (47%), zone 2 (Z2) in 62 eyes (21.7%), zone 3 (Z3) in 76 eyes (26.7%), N/D in 13 cases (4.6%). Average follow up was 9.8 months.44 eyes required enucleation; 12 eyes underwent primary enucleation and 32 secondary. Retinal detachment (RD) was noted in 51 eyes within 10 days of injury presentation; 17 presented with RD 10 days post injury. 3 eyes presented with endophthalmitis; of which. 2 eyes underwent pars plana vitrectomy (PPV) as the primary surgery. 71 eyes presented with cataract. 5 more presented with cataract after 10 days. Of these, 63 eyes underwent lensectomy.The logMar visual acuity (VA) data is as follows. Average initial VA was 3.10; and average final VA was 2.46. 62 (21.8%) eyes presented with NLP but only 51 of 62 remained NLP following surgery. However, 63 (22.1%) eyes had a final VA of NLP. Eyes with a Z1 injury presented with a mean initial VA of 2.52; zone 3 of 3.94. The mean best corrected final VA for Z1 was 1.60; Z3 eyes was 3.65.Of 285 eyes, 76 required PPV for RD (26.7%). 7 of these had PPV as part of the primary globe repair. The anatomic success after first PPV was 37 of 76 (49%); overall success after all RD repairs was 52 of 76 (68%). The mean PPVs required for RD repair was 1.7. The incidence of RD was highest in Z3 eyes (59% of Z3 eyes); also, the incidence of secondary surgeries after the primary globe repair was the highest in Z3 eyes (63% of Z3 eyes).

Conclusions: : Eyes with open globe injury should receive emergent aggressive treatment since some eyes may have a fair visual potential; in our series 40% (115/285) eyes recovered to 20/200 or better VA. Eyes with Z3 injury tend to develop more post-operative complications, and should be monitored closely.

Keywords: trauma • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: prevalence/incidence 
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