The value of mechanical injury classifying system on the prognostic judgement of the open-globe injuries

Abstract

Objective To evaluate the value of mechanical injury classifying system on prognostic judgement of the open-globe injuries. Methods Medical records of 142 eyes of 140 consecutive patients with open-globe injury were retrospectively reviewed. Specific variables of a system for classifying mechanical injuries of the eye were analyzed including the type of injury, grade of injury, zone of injury, and relative afferent pupillary defect. Additional variables, such as hyphema, traumatic cataract, vitreous hemorrhage, secondary glaucoma, optic nerve contusion, elapsed time between the injury and presentation, number of operation, prolapse of intraocular contents, and length of the wound were also included in the analysis. Final visual outcome were recorded. Data were analyzed for predictors with univariate analysis and multivariate logistic regression analysis. Results After a follow-up of 6 months, the visual acuity was 0.5 or better in 29 eyes (20.42%), and worse than 0.5 in 113 eyes (79.58%). According to univariate analysis results, the following parameters were predictors of visual outcome including type of injury, grade of injury, zone of injury, number of operation, length of the wound, and elapsed time between the injury and presentation. However, multivariate logistic regression analyses revealed that zone of injury, grade of injury, type of injury and length of the wound were the only significant factors for visual outcome. Conclusion Zone of injury, grade of injury, type of injury and length of the wound are significant prognostic factors for visual outcome in open-globe injury. The classification system may be an useful prognostic tool for visual outcome in open-globe injury. Key words: Injury, open-globe; Classification; Visual acuity; Prognosis