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J. Son, A. M. Bauza, S. N. Patel, P. D. Langer, M. Zarbin, N. Bhagat; Characteristics of Open Globe Injuries Leading to Enucleations; A 11-Year Retrospective Review. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5377.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the characteristics of all enucleated eyes that presented to New Jersey Medical School from 1997 to May 2009 with traumatic open globe injuries.
Retrospective chart review. Following characteristics of both enucleated and non-enucleated eyes were collected and compared: mean age of patient, gender, type of trauma, presence of APD, presenting visual acuity, zone of trauma, type of intraocular foreign body (IOFB), time of presentation after injury, presence of retinal detachment (RD), vitreous hemorrhage (VH), and lens status at presentation. Chi-squared contingency table was used for statistical data analysis.
Of 559 eyes that presented with traumatic open globe injuries to the UH, 88 (15.7%) were enucleated. The male to female ratio for enucleated eyes were 67 to 21 (76% male, 24% female). The mean age was 39.9 years (range: 7 to 96). There were 42 right eye and 46 left eye enucleations. The presenting visual acuity (VA) was no light perception (NLP) in 60 eyes (68%) and LP in 15 (17%); however, 86 of 88 eyes were NLP at enucleation. Type of trauma included rupture in 54 eyes (64%), penetration in 21 eyes (24%), and perforation in 11 eyes (13%). Location of injury was type 1 in 15 (17%) eyes, type 2 in 13 (15%) eyes; type 3 in 55 (62%) eyes. The three most common mechanisms of injury were assault injuries in 20 eyes, followed by blunt-object injuries in 17 eyes. There were 11 gunshot injuries. There were 6 eyes with intraocular foreign bodies. Endophthalmitis was noted in 3 eyes. 20 eyes underwent primary and 68 underwent secondary enucleation. Average time from injury to enucleation was 39 days (range: 1 day to 2 years 11 month). Characteristics or clinical findings that occurred significantly higher in enucleated eyes were: 0-20 age group (p=0.044, Χ2=4.051), aphakia (p<0.0001, Χ2=17.807), vitreous hemorrhage (p=0.007, Χ2=7.268), retinal detachment (p<0.0001, Χ2=19.344), ruptured and perforating globe injuries (p<0.0001, Χ2=21.187 and p<0.0001, Χ2=45.362), presence of afferent pupillary defect (p<0.0001, Χ2=76.883), presenting visual acuities of NLP (p<0.0001, Χ2=152.01), and zone 3 location of eye trauma (p<0.0001, Χ2=26.106).
Commonly documented clinical findings and characteristics of eye trauma may serve as useful prognostic indicators of potential enucleation in open-globe trauma patients.
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