Abstract
BackgroundOcular trauma is an important cause of visual loss worldwide. Improvements in our knowledge of the pathophysiology and management of ocular trauma during the past 30 years, in conjunction with advances in the instrumentation and techniques of ocular surgery, have improved the efficacy of vitreoretinal surgery in injured eyes. The aim of the current study was to determine the visual outcomes and prognostic factors of open-globe injuries in the Japanese population.MethodsRetrospective study of 59 eyes of 59 patients presented with open globe injuries between September 2008 and March 2014 at Nagasaki University Hospital was conducted.Demographic factors including age, gender, and clinical data such as cause of injury, presenting visual acuity (VA), location of injury, type of injury, lens status, presence of intraocular foreign body, types of required surgeries, and final VA were recorded. According to the classification of Ocular Trauma Classification Group, wound location was classified into three zones. Chi-square test was used to compare presented data.ResultsOut of the 59 patients, 46 were placed in the Light Perception (LP) group, and 13 were placed in the No Light Perception (NLP) group. Work-related trauma was the most common cause (27 eyes) followed by falls (19eyes). Work-related trauma was common in males (P = 0.004), while falls was significantly common in females (P = 0.00001). Zone III injuries had statistically significantly poor prognostic factor compared to other zones (P = 0.04). All cases of NLP group (100%) presented with rupture globe. Poor VA at first visit (P = 0.00001), rupture globe (P = 0.026), history of penetrating keratoplasty (PK) (P = 0.017), retinal detachment (RD) (P = 0.0001), vitreous hemorrhage (VH) (P = 0.044), and dislocation of crystalline lens (P = 0.0003) were considered as poor prognostic factors.ConclusionPoor VA at first visit, rupture globe, zone III injuries, history of penetrating keratoplasty, RD, VH, and dislocation of crystalline lens were found to be poor prognostic factors. PPV had a good prognostic value in open globe injuries associated with posterior segment involvement.
Highlights
Ocular trauma is an important cause of visual loss worldwide
Patient demographics This study evaluated 59 patients (46 in the Light Perception (LP) group and 13 in the No Light Perception (NLP) group)
The mean age was 56.7 ± 21.8 years in the LP group and 62.3 ± 21.7 years in the NLP group, with no significant difference found between the two groups (p = 0.21)
Summary
Ocular trauma is an important cause of visual loss worldwide. The aim of the current study was to determine the visual outcomes and prognostic factors of open-globe injuries in the Japanese population. Ocular trauma is a prominent cause of visual disability and, depending on the sample population, can contribute up to 65% of the cases of unilateral blindness worldwide. An open-globe injury is defined as a full thickness wound of the eye wall (full injury of the sclera, cornea, or both) with this vision-threatening condition often leading to blindness. Public health campaigns have been organized to prevent eye injuries, open-globe injuries are still too frequent. It has been shown that open-globe injuries result in more hospitalization and a poorer visual outcome compared to closed globe injuries [8, 9]
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