Abstract
BackgroundOcular trauma is a major cause of vision loss, especially in the young patients, and is the leading cause of unilateral blind in China. ObjectiveThe aims of this report are to analyze ciliary and choroidal lesion characteristics and outcomes of a group of patients with ruptured globe injuries and discuss finding a more effective treatment protocol. Here we report our experience treating ruptured globe injuries. MethodsSeventy-five patients (75 eyes) with a diagnosis of ruptured globe injuries were selected from 264 patients with open globe injuries at the Shierming Eye Hospital of Shandong Province between January 2009 and December 2011. General information and clinical characteristics such as ciliary and choroidal lesion features were reviewed. ResultsOf the 75 patients, 85.3% were men, and the average age of the patients was 37.2 years (range, 6–63 years). The right eye was injured in 52.0%; enucleation was performed in 9 patients. There was no light perception, in the final corrected visual acuity in another 3 patients. The ratio of better visual acuity (better than 0.1) increased from 0 preoperatively to 16.0% postoperatively. Among the 75 patients with ruptured globe injuries, 13 had ciliary injury and 47 (62.7%) had choroidal injuries. Both ciliary and choroidal injuries were detected in 15 patients. Retinal tissue incarceration during sclera suturing was usually the vital point leading to unfavorable results. ConclusionsRuptured globe injury usually results in severe visual acuity damage. Active treatment could help to restore visual acuity in patients to some degree. Some effective treatment protocols for ruptured globe injuries could be followed. Some unsuitable procedures in primary treatment should be avoided to achieve a better prognosis.
Highlights
Ocular trauma is a very important cause of visual damage, especially in young patients.[1]
According to the Birmingham Eye Trauma Terminology (BETT) criteria,[3,4] rupture is defined as a full-thickness wound of the eye wall caused by a blunt object
The results showed that the prognosis of ciliary injury was much better than in the other 2 groups (a 1⁄4 0.05, w2 1⁄4 57.817 [w2 tests], P o 0.001)
Summary
Ocular trauma is a very important cause of visual damage, especially in young patients.[1]. In the United States, eye injuries cost 4 $300 million per year due to lost productivity, medical expenses, and workers’ compensation.[2] In China, ocular trauma is the primary cause of unilateral blindness. The preoperative visual acuity of patients with severe ruptured globe injuries was poor mostly. Sometimes the visual acuity prognosis of these patients depended on whether they received suitable primary treatment. We report here our experience in treating severe ruptured globe injuries, which may be helpful for junior oculists. Objective: The aims of this report are to analyze ciliary and choroidal lesion characteristics and outcomes of a group of patients with ruptured globe injuries and discuss finding a more effective treatment protocol. Conclusions: Ruptured globe injury usually results in severe visual acuity damage. Active treatment could help to restore visual acuity in patients to some degree. Some unsuitable procedures in primary treatment should be avoided to achieve a better prognosis
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