Abstract
Purpose :
To analyze visual, surgical, and anatomic outcomes of open globe injuries (OGIs).
Methods :
Of 349 consecutive patients who presented to Yale-New Haven Hospital with OGI between 2003 and 2013, charts of 206 consecutive patients with at least 6 months of follow-up were reviewed. Multivariate statistical analysis was used to identify predictors of visual outcome, number of surgical interventions required, and anatomic outcome (salvaged globe, phthisis, or enucleation).
Results :
Gender was male in 72% of cases. Age (mean ± SD) was 43.5 ± 24.46 (Range 1-94). Final follow-up (mean ± SD) was 28.02 months +/- 23.27 (range 6-108). Multivariate analysis demonstrated decreased likelihood of final BCVA ≥20/40 in patients with retinal detachment (initial or delayed, odds ratio (OR)=0.064, p<0.0001), decreased likelihood of final BCVA ≥20/400 in patients with RAPD (OR=0.031, p=0.0024) or subsequent PVR (OR=0.028, p=0.0015), increased likelihood of NLP outcome with initial NLP (OR=13.693, p=0.0011) and RAPD (OR=22.882, p=0.0001), increased likelihood of phthisis with initial RAPD (OR=24.860, p=0.0060) and subsequent PVR (OR=18.892, p=0.0125), increased likelihood of enucleation with initial RAPD (OR=26.476, p=0.0040), and increased likelihood of multiple surgical interventions with age >65 (OR=11.180, p=0.0042), 360° subconjunctival hemorrhage (OR=9.735, p=0.0084), lens injury (OR=26.405, p<0.0001), endophthalmitis (OR=145.468, p=0.0190), and retinal detachment (initial or delayed, OR=4.661, p=0.0213).
Conclusions :
Retinal detachment, PVR, and RAPD are prognostic for poor visual and anatomic outcome after OGI. Age at presentation, 360° subconjunctival hemorrhage, lens injury, retinal detachment, ocular trauma score and endophthalmitis are surgical prognostic indicators. PVR and RAPD are important predictors of phthisis.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.