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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)
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.
Retrospective case series.
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).
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.
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