Abstract
Purpose :
To describe the characteristics and outcomes of open globe injuries treated at University Hospital (Newark, NJ), a level 1 trauma center.
Methods :
A retrospective review of open globe injuries (OGI) that were treated at University Hospital between July 2017 and July 2019. Eyes with OGIs were identified by CPT codes and then confirmed by chart review. Visual acuity outcomes were compared in eyes that underwent primary repair <24 hours after injury (early) to those with repair >24 hours after injury (late). Visual acuity (VA) was measured at presentation after the injury (baseline) and at each follow up visit after open globe repair (OGR).
Results :
A total of 109 eyes that underwent OGR were included in the study. Sixty-six eyes had early repair while forty-three eyes had late repair. The final follow up visits for the early and late groups were 163±153 and 138±130 days after primary repair, respectively (Table 1). In logMAR, VA at the final follow up visit improved from baseline VA in the early (2.0±0.9 to 1.6±1.1; p<0.01) and late (1.7±1.0 to 1.4±1.1; p<0.01) repair groups. In eyes with logMAR <1.9, which corresponds to counting fingers (CF), early repair was associated with a significant improvement in VA at the final follow-up visit (0.7±0.4 to 0.2±0.2; p=0.02), whereas late repair was not (0.6±0.3 to 0.6±0.7; p=0.95) (Table 2). Conversely, the early and late repair groups had similar VA outcomes in eyes with a baseline logMAR ≥1.9 (early: 2.5±0.4 to 2.1±0.8 and late: 2.5±0.4 to 2.0±0.9; both p<0.05). There was one case of endophthalmitis in each group, while the early repair group had four enucleations compared to one in the late group. The mean number of secondary procedures (early: 0.8±1.0, late: 0.6±0.8; p=0.33) as well as the number of eyes with cataract or retina related procedures did not differ between the early and late repair groups. Data from longer term follow up are pending.
Conclusions :
In eyes with CF vision or worse after an OGI, early and late repair are associated with similar final VA. However, in eyes with vision better than CF, early repair led to a significant improvement in final VA whereas late repair did not. This is a single site retrospective study and it is possible that patients with more severe OGI were more likely to present earlier.
This is a 2020 ARVO Annual Meeting abstract.