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C. M. Andreoli, M. T. Andreoli, R. Wee, C. E. Kloek; Surgical Rehabilitation After Open Globe Injury. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4665. doi: https://doi.org/.
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Open globe injuries frequently carry a poor prognosis. Eyes which are salvageable are at risk for numerous complications such as hemorrhage, glaucoma, cataract, retinal detachment and infection which may necessitate additional surgery. Here we explore the post-operative course of patients with open globe injuries. This information will allow us to better anticipate the post-operative needs of these trauma patients.
Review of all open globe repairs (OGR) at the Massachusetts Eye and Ear Infirmary between January 1, 2000 and August 1, 2008.
678 consecutive patients surgically repaired for open globe injury were analyzed. The average follow-up was 6 months (1 day to 7 years). A total of 1216 surgeries were performed on these patients at our institution. 328 patients underwent a single surgery. The remaining 350 patients underwent multiple surgical procedures (2-9) with an average of 2.5 surgeries per patient. The average time from first to last surgery was 235 days.50 patients underwent secondary enucleation. 197 patients underwent a total of 311 pars plana vitrectomies. 85 patients received a scleral buckle, 27 underwent penetrating keratoplasty, 103 had a secondary intra-ocular lens placed, and 7 underwent glaucoma surgery.Patients who underwent lensectomy at primary repair were more likely to require multiple surgeries (see table). A higher percentage of patients undergoing a single surgery went on to recover good vision (see table).
A large proportion of patients suffering open globe injuries will need additional surgery following initial surgical repair. When additional surgeries are required, it is most commonly by a vitreo-retinal surgeon performing a pars plana vitrectomy or scleral buckle. Patients should be adequately counseled pre-operatively, and physicians should anticipate sub-specialty consultation.
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