June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Open Globe Repairs in the United States 2014-2018: Incidence, risk factors and visual outcomes - An IRIS® Registry (Intelligent Research in Sight) Analysis
Author Affiliations & Notes
  • Maurizio Tomaiuolo
    Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Fasika Woreta
    Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
  • Alexander Li
    Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Yoshihiro Yonekawa
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • James Sharpe
    Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Qiang (Ed) Zhang
    Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Zeba A Syed
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Deepak Ramesh
    Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Alice Carlyle Lorch
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Nathan Hall
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Ankoor Shah
    Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Grant Justin
    Ophthalmology, Duke University, Durham, North Carolina, United States
  • Leslie Hyman
    Vision Research Center, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Maurizio Tomaiuolo None; Fasika Woreta None; Alexander Li None; Yoshihiro Yonekawa None; James Sharpe None; Qiang Zhang None; Zeba Syed None; Deepak Ramesh None; Alice Lorch None; Nathan Hall None; Ankoor Shah None; Grant Justin None; Leslie Hyman None
  • Footnotes
    Support  American Society of Ocular Trauma
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4249. doi:
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      Maurizio Tomaiuolo, Fasika Woreta, Alexander Li, Yoshihiro Yonekawa, James Sharpe, Qiang (Ed) Zhang, Zeba A Syed, Deepak Ramesh, Alice Carlyle Lorch, Nathan Hall, Ankoor Shah, Grant Justin, Leslie Hyman; Open Globe Repairs in the United States 2014-2018: Incidence, risk factors and visual outcomes - An IRIS® Registry (Intelligent Research in Sight) Analysis. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4249.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Open globe injuries (OGI) are an important cause of visual impairment worldwide. This retrospective cohort analysis evaluates incidence and risk factors associated with open globe repairs (OGR) and visual acuity (VA) outcomes after surgery in the American Academy of Ophthalmology IRIS Registry.

Methods : Patients with OGR were identified by Current Procedural Terminology codes (65275, 65280, 65285, 65286, 65235, 65260, 65265) from 2014 to 2018 in the IRIS Registry. Annual and 5-year incidence rates per 100,000 persons were calculated. Factors associated with OGR and VA <20/40 and VA <20/200 at final follow up (3 to 12 months post OGR) were evaluated using multivariable logistic regression models adjusting for sex, race, ethnicity, US region, concurrent and subsequent surgeries, and baseline VA. Statistical analyses were performed in R.

Results : 15,316 OGR’s were identified during the study period; 5-year incidence was 30.1/100,000. Annual incidence ranged from 10.9 to 12.7/100,000. OGR was positively associated with older v younger ages <21 yrs, e.g. > 80 yrs (OR, 4.9 [CI: 4.1-6.0]); male v female (OR, 3.1 [CI: 2.7-3.6]); Black v White race (OR, 1.7 [CI, 1.5-2.1]); Hispanic v Non Hispanic ethnicity (OR, 1.4 [CI, 1.2-1.7]); living in the South (OR, 1.40 [CI, 1.33-1.47]) and West (OR- 1.29 [CI, 1.21-1.36]) (v Midwest) regions and inversely associated with Asian v White race (OR- 0.5 [CI, 0.3-0.8]). Vision impairment final follow up was associated with VA <20/200 at presentation (20/200 v better than 20/40 - OR, 11.6 [CI, 8.0-155.6]); older age e.g. 80+ y (v < 21 y) (OR, 5.8 [CI, 3.2-10.7]); and Black race (v White) (OR, 1.8 [CI, 1.3-2.5]). Risk factors were similar for VA < 20/200 post OGR. Among all OGR patients presenting with VA 20/200 or worse, VA improved to 20/40 or better at follow up in 19% (331/1748) of patients; VA improved to better than 20/40 in only 10% (20/ 192) of Black OSR patients.

Conclusions : Our findings support previously established risk factors associated with OGR of older age and male sex and bring to light racial disparities in risk of OGI and poor visual outcomes that warrant further exploration.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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