The effect of injury type and location on the prognosis of the patients with open globe injuries

Abstract

Objective:  Investigation of the effect of the globe injury site and the globe injury type on the postoperative results in the patients with a relatively softer open globe injury (OGI) was aimed. Methods: Medical records of the patients with OGI due to blunt or penetrating trauma were analyzed retrospectively. The patient cohort was divided into laceration and rupture groups. The location of injury was evaluated in zones (I-II-III). Presence and type of the complication (cataract, retinal detachment, etc.) were evaluated. Final best-corrected visual acuity (BCVA) was evaluated as the primary outcome measure. Results: Seventy eyes of 70 patients with OGI were included in the study. While 58 eyes (82.9%) had lacerations, 12 eyes (17.1%) had ruptures. Among the 52 patients with lacerations for whom there was an available BCVA data, 13 (25%) patients showed no change, 32 (61.5%) showed an increase, and 7 (13.5%) showed a decrease in BCVA. Among the 11 patients with ruptures, 2 (18.2%) patients showed no change and 9 (81.8%) showed an increase in BCVA. A complication was observed in 23 (44.2%) patients with laceration and 4 (33.3%) patients with rupture (p: 0.474). No difference was detected in terms of the complication rate between the patients having a different zone of injury. However, final BCVA was lower in those with Zone III injury in comparison to those with Zone II injury (p: 0.028). Conclusion: Although the injury type was thought to have an effect on the final BCVA of the patients with OGI, no difference was detected between the patients with laceration and rupture. Zone III injuries resulted in lower preoperative BCVA values. However, despite a significant difference between Zone II and III injuries, no significant difference was observed in terms of the final BCVA between the patients with Zone I and those with Zone III injuries.

Keywords

• open globe injury,injury location,laceration,rupture,penetrating trauma

Kaynakça

1. 1. Al-Mezaine HS, Osman EA, Kangave D, Abu El-Asrar AM. Prognostic factors after repair of open globe injuries. J Trauma. 2010;69(4):943–7.
2. 2. Pieramici DJ, Sternberg P, Aaberg TM, Bridges WZ, Capone A, Cardillo JA, et al. A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group. Am J Ophthalmol. 1997 Jun;123(6):820–31.
3. 3. Négrel AD, Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998;5(3):143–69.
4. 4. Pimolrat W, Choovuthayakorn J, Watanachai N, Patikulsila D, Kunavisarut P, Chaikitmongkol V, et al. Predictive factors of open globe injury in patients requiring vitrectomy. Injury. 2014;
5. 5. Feng K, Hu YT, Ma Z. Prognostic Indicators for No Light Perception After Open-Globe Injury: Eye Injury Vitrectomy Study. Am J Ophthalmol. 2011 Oct;152(4):654-662.e2.
6. 6. Page RD, Gupta SK, Jenkins TL, Karcioglu ZA. Risk factors for poor outcomes in patients with open-globe injuries. Clin Ophthalmol. 2016;10:1461–6.
7. 7. Agrawal R, Ho SW, Teoh S. Pre-operative variables affecting final vision outcome with a critical review of ocular trauma classification for posterior open globe (zone III) injury. Indian J Ophthalmol. 2013;61(10):541–5.
8. 8. Agrawal R, Naigaonkar R, Desai S, Rao G, Ou X. Prognostic factors for vision outcome after surgical repair of open globe injuries. Indian J Ophthalmol. 2011;59(6):465.

9. 9. Feng K, Shen L, Pang X, Jiang Y, Nie H, Wang Z, et al. Case-control study of risk factors for no light perception after open-globe injury: Eye injury vitrectomy study. Retina. 2011 Nov;31(10):1988–96.
10. 10. Kuhn F, Mester V, Berta A, Morris R. [Epidemiology of severe eye injuries. United States Eye Injury Registry (USEIR) and Hungarian Eye Injury Registry (HEIR)]. Ophthalmologe. 1998 May;95(5):332–43.
11. 11. Schmidt GW, Broman AT, Hindman HB, Grant MP. Vision Survival after Open Globe Injury Predicted by Classification and Regression Tree Analysis. Ophthalmology. 2008;
12. 12. Kuhn F, Morris R, Witherspoon CD, Mester V. The Birmingham Eye Trauma Terminology system (BETT). J Fr Ophtalmol. 2004 Feb;27(2):206–10.
13. 13. Savar A, Andreoli MT, Kloek CE, Andreoli CM. Enucleation for Open Globe Injury. Am J Ophthalmol. 2009 Apr;147(4):595-600.e1.
14. 14. Guven S, Durukan AH, Erdurman C, Kucukevcilioglu M. Prognostic factors for open-globe injuries: variables for poor visual outcome. Eye. 2019 Mar;33(3):392–7.
15. 15. Oner A, Kekec Z, Karakucuk S, Krakucuk S, Ikizceli I, Sözüer EM. Ocular trauma in Turkey: a 2-year prospective study. Adv Ther. 23(2):274–83.
16. 16. Qi Y, Zhang F-Y, Peng G-H, Zhu Y, Wan G-M, Wang W-Z, et al. Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China: 2006-2011. Int J Ophthalmol [Internet]. 2015 [cited 2019 Jul 12];8(1):162–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25709927
17. 17. Arici C, Hagverdiyeva S, Mergen B, Mangan MS, Arslan OS. First report of traumatic scleral rupture after penetrating keratoplasty. Turkish J Trauma Emerg Surg [Internet]. 2019;25(5):0. Available from: https://dx.doi.org/10.5505/tjtes.2018.55014
18. 18. Gursoy H, Bilgec MD, Sahin A, Colak E. A Possible Regression Equation for Predicting Visual Outcomes after Surgical Repair of Open Globe Injuries. J Ophthalmol. 2017;2017:1320457.
19. 19. Sahin Atik S, Ugurlu S, Egrilmez ED. Open Globe Injury: Demographic and Clinical Features. J Craniofac Surg. 2018 May;29(3):628–31.
20. 20. Andreoli CM, Andreoli MT, Kloek CE, Ahuero AE, Vavvas D, Durand ML. Low Rate of Endophthalmitis in a Large Series of Open Globe Injuries. Am J Ophthalmol. 2009 Apr;147(4):601-608.e2.
21. 21. Kong GYX, Henderson RH, Sandhu SS, Essex RW, Allen PJ, Campbell WG. Wound-related complications and clinical outcomes following open globe injury repair. Clin Experiment Ophthalmol. 2015;43(6):508–13.
22. 22. Essex RW, Yi Q, Charles PGP, Allen PJ. Post-traumatic endophthalmitis. Ophthalmology. 2004 Nov;111(11):2015–22.
23. 23. Duch-Samper AM, Menezo JL, Hurtado-Sarrió M. Endophthalmitis following penetrating eye injuries. Acta Ophthalmol Scand. 1997 Feb;75(1):104–6.