Investigation on surgical outcomes and treatment strategy of open globe injury with corneal blood staining

Abstract

Objective To investigate on different outcomes of the opening injured eyes with corneal blood staining after vitreoretinal surgery using temporary keratoprosthesis and replacement of the blood stained cornea.Methods From January 2002 to June 2008,medical records of 16 eyes undergoing vitreoretinal surgery using temporary keratoprosthesis for opening globe injury and corneal blood staining were studied.The blood stained corneas were sutured back at the end of the surgery and the eyes were tamponade with silicone oil.Only patients with ≥24 months follow-up were included.Data retrieved from the eye injuryregistry chart including the types of the eye trauma,the status of the eye after the trauma,the intraoperative findings,and the different outcomes and prognoses of the injured eyes were reviewed.Results Among the 16 patients,15 were male and 1 was female.Mean age was (32.3 ± 9.5) years (20 ～53years),mean length of time between the injury and the primary vitreoretinal surgery was (18.8 ± 12.3) days (8 ～57days).Subtypes of the injury include 15 globe rupture,1 penetrating injury,1 intraocular foreigen body.All eyes were suffered from zone 3 open globe injury.Intraoperative findings include 1 total retinal loss,15 total retinal detachment,11 funnel shape retinal detachment,13 retinal incarceration,4 choroidal dialysis.Mean follow-up time was (37.9 ± 11.7) months (24 ～ 60months).Retinal reattachments were achieved in 14 eyes and 1 eye underwent a second reattachment surgery.Final visual outcome include 4 eyes with no light perception,5 eyes with light perception ～ hand motion,3 eyes with finger count ～ 0.08,4eyes with ≥0.1.The overall outcomes were as follows:3 eyes were enucleated,7 eyes needed long term silicone oil temponade,silicone oil were removed in 6 eyes,among them,blood stained cornea were largely resolved in 3 eyes and keratoplasty were not needed,1 patients underwent bilateral corneal exchange,only 2 eyes finally received penetrating keratoplasty.Conclusion Open globe injury with corneal blood staining may have different outcomes,only a small portion of eyes is worth of undergoing keratoplasty. Key words: Corneal blood staining,Injury,open globe ; Vitreoretinal surgery ;