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J. A. Rosdahl, R. Wee, M. T. Andreoli, C. M. Andreoli; Motor Vehicle Accident-Associated Ruptured Globes at the Massachusetts Eye & Eye Infirmary. Invest. Ophthalmol. Vis. Sci. 2008;49(13):623.
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© ARVO (1962-2015); The Authors (2016-present)
We report the outcomes of patients who presented to a large ophthalmic trauma service with open globe injuries sustained by motor vehicle accidents.
We carried out an analysis of open globe injuries associated with motor vehicle accidents presenting to the ophthalmic trauma service at the Massachusetts Eye & Ear Infirmary from 1999 until 2006.
There were 25 motor vehicle accident-associated open globe injuries of the 692 total number of open globe injuries from all causes (3.6%). Injuries occurred more commonly in males (18 of 25, 68%). The ages ranged from 19 to 88 years (mean 48, median 46). The right eye was more commonly affected (18 of 25, 68%). Four patients required enucleation (16%), which is twice the overall rate of enucleation for open globe injuries. Intraocular foreign bodies were present in 4 of 25 patients (16%). No patients developed endophthalmitis or sympathetic ophthalmia. Post-operative best corrected visual acuity was no light perception in 4 cases (16%), light perception or hand motion in 7 cases (28%), counting fingers or 20/400 in 3 cases (12%), better than 20/200 in 9 cases (36%), better than 20/40 in 6 cases (24%), and 20/20 in 3 patients (12%). Motor vehicle accident-associated open globe injuries were associated with post-operative complications such as hyphema (7 cases, 28%), retinal detachment (7 cases, 28%), cataract (4 cases, 16%), vitreous hemorrhage (9 cases, 36%), choroidal detachment (1 case, 4%), retinal hemorrhage (3 cases, 12%), and glaucoma (3 cases, 12%). One patient required a corneal transplant. Six patients required vitrectomy (24%), including two who required a scleral buckle as well. Three patients (12%) had secondary intraocular lenses placed.
Motor vehicle accidents are common cause of morbidity and mortality, accounting for 14.9 deaths per 100,000 Americans. Open globe injuries sustained during motor vehicle accidents are more likely to require enucleation and more than half are left with poor vision (56% with 20/400 or worse). Most patients had post-operative complications, including hyphema, retinal detachment, vitreous hemorrhage, and retinal hemorrhage (80%). However, approximately one quarter of patients are left with good vision (24% with 20/40 or better vision).
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