Abstract
Purpose::
To report the characteristics, demographics and clinical outcomes of patients who presented with ruptured globe (RG) injuries and associated intraocular foreign body (IOFB) between January 1998 through December 2005 to the University Hospital, New Jersey Medical School, Newark, NJ.
Methods::
Medical records of patients with RG and IOFB between 1998 & 2005 were reviewed retrospectively to collect the following data - demographics, etiology of trauma, surgical procedures performed, types of IOFB, and final functional and structural outcome.
Results::
Thirty-eight RG patients with IOFB were identified. Thirty-six (94.7%) were males and 2 (5.3%) were females. Seventeen patients (44.7%) were Hispanic, 12 (31.6%) Caucasian, 6 (15.8%) African American, 2 (5.3%) Middle Eastern, and 1 Asian. The average age was 31.1 years and ranged from 14 to 50 years old. There were 26 (68.4%) metallic IOFB, 6 (15.8%) glass, 1 (2.6%) bebe gun pellet, 1 wood, and 4 (10/5%) unknown. Ten injuries (26.3%) were sustained at home, 11 (28.9%) at work, 5 (13.2%) from motor vehicle accidents, and 12 (31.6%) were unknown. One patient reported wearing protective eyewear at the time of injury, 1 patient was wearing regular glasses, and 1 patient was wearing contact lenses. Thirteen patients (34.2%) had anterior segment (AS) IOFB (Group A) and 25 patients (65.8%) had posterior segment (PS) IOFB (Group B). Twenty seven patients (71.1%) had corneal lacerations only, 8 (21.1%) had corneal and sclera lacerations, and 3 (7.9%) had sclera lacerations only. Sixteen patients (42.1%) had traumatic cataract at the time of initial presentation. All patients in Group A had primary repair of their AS as their initial surgical procedure whereas all but 1 patient in Group B had primary vitrectomy and IOFB removal as their primary surgical procedure. Patients in Group A underwent an average of 1.15 surgeries in the following1 year and 1.80 in Group B. Average Ocular Trauma Score (OTS) was 63.2 for Group A and 50.5 for Group B, both category 2. Average post-operative best corrected visual acuity (BCVA) in Log MAR was 0.32 for the 10 patients with 1 month follow up in Group A, 0.97 for the 13 patients with 6 month follow-up in Group B, and 0.74 for the 10 patients with 1 year follow-up in Group B. One patient in Group A and 2 patients in Group B underwent secondary enucleation.
Conclusions::
RG with IOFB are significantly higher in males than in females. Patients with posterior segment IOFB have a poorer visual outcome, require more surgical procedures, and have a lower OTS on average than those with RG and anterior segment IOFB.
Keywords: trauma • vitreous • retina