Abstract
Purpose: :
To evaluate posterior segment trauma requiring surgery and to establish possible prognostic factors that predict the functional and anatomical outcome managed at the Singapore National Eye Centre over the period of 1999 –2005.
Methods: :
Retrospective review of the case records of all posterior segment trauma that required surgery that were entered in the trauma registry. They were evaluated in terms of the demographics of the patient and specific variables according to the Birmingham eye trauma terminology, such as: type of injury (mechanism of injury), grade of injury (presenting visual acuity), presence of relative afferent pupillary defect and zone of injury (location) and outcome in terms of functional and anatomical outcome at one, three and six months after the injury. The type, number of surgeries and any complications were also documented
Results: :
A total of 60 patients were evaluated. The mean age of the patients was 33 years of age with majority of patients being between 20–40 years of age. 89% of the patients were male. The age extremes occurred in the group who were classified as home accidents, which accounted for 14.5% of the injuries. The rest of the injuries were related to work and accounted for 85.5% of the injuries. The presenting visual acuity (p<0.001), presence of intraocular foreign body (p<0.001), retina detachment (p<0.001) and relative afferent pupillary defect (p=0.02) were all shown to be important predictors of the final visual outcome. However multivariate analysis showed that the presenting visual acuity (p=0.01) was the only significant factor for determining the final visual outcome.
Conclusions: :
The use of the standardized trauma classification allows us to have an unambiguous evaluation of the data. The results show that the grade of the injury (presenting visual acuity), presence of relative afferent pupillary defect, retina detachment and intraocular foreign body are important prognostic factors in terms of the visual outcome of such posterior segment trauma patients. This allows us to provide more appropriate and accurate prognosis and advice to such patients based on their ocular trauma scores on presentation. The presenting visual acuity also appears to be the most significant factor in determining the visual outcome in such patients.