Abstract
Purpose :
At the time of open globe injury, it may be difficult for clinicians to predict which eyes are at highest risk for ultimately requiring enucleation. We performed a 17-year retrospective cohort study to report outcomes and risk factors for enucleation following open globe injury (OGI) to better aid clinicians counseling patients at OGI diagnosis.
Methods :
A retrospective cohort study of all patients who presented to the University of Michigan with open globe injury (OGI) and were surgically managed between January 2000 and July 2017 was conducted. At least 30 days of follow-up was required. All eyes that ultimately underwent enucleation following OGI were identified and their clinical course analyzed. The main outcome measured was the rate of enucleation after OGI.
Results :
There were 588 eyes meeting inclusion criteria. The mean patient age was 40.75 ± 25.1 (range 1 – 91) and 441/585 (75.2%) patients were male. Average follow up time was 1079.8 ± 1895.7 days. 117/588 eyes (19.9%) required enucleation after OGI, with 95/117 (81.2%) undergoing enucleation less than 30 days from injury. For all eyes, the average presenting logMAR vision was 2.11 ± 1.01 (Snellen equivalent between counting fingers and hand motion). In eyes that underwent enucleation, the mean presenting logMAR vision was 2.91 ± 0.470 (Snellen equivalent between hand motion and light perception). The most common mechanism of injury requiring enucleation was globe rupture, 89/117 (76.1%), with 14/117 (12.0%) eyes having penetrating injuries and 14/117 eyes (12.0%) having perforating injuries. The mean age of patients that underwent enucleation was 45.6 ± 22.5 (range 3 – 91).
Conclusions :
Open globe injuries (OGI) are often visually devastating and in a significant number of cases ultimately require enucleation. Despite emergent closure within 24 hours, 19.9% of eyes diagnosed with OGI require enucleation. 81.2% of these eyes required enucleation within 30 days of injury. Eyes that underwent enucleation tended to have worse presenting visual acuity, with mean presenting logMAR vision of 2.91 ± 0.470 (Snellen equivalent between hand motion and light perception), compared to a mean presenting logMAR vision of 2.11 ± 1.01, in all eyes with OGI.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.