Clinical, radiographic, and intraoperative risk factors for retinal detachment after open globe injury

PurposeTo explore the long-term efficacy of novel choroidal suturing methods including trans-scleral mattress suturing (TSS) and intraocular suturing (IOS) in the treatment of choroidal avulsion.DesignProspective cohort, hospital-based study.MethodsA total of 24 patients who were diagnosed with choroidal avulsion were enrolled in this study. The demographic characteristics, baseline information of trauma, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were collected before surgery, and the anatomic abnormities of the globe were recorded before or during surgery. All patients were diagnosed with choroidal avulsion and underwent choroid suturing treatment during vitrectomy, postoperative functional variables including BCVA and IOP, anatomic variables including retinal and choroidal reattachment rate, and silicone oil migration rate, which were recorded at the regular follow-ups at least 1 year after surgery.ResultsAll patients with open globe injury involved zone III, 70.8% of the patients presented with two quadrants of the avulsed choroid, and 29.2% with one quadrant involved; moreover, all patients had complications with retinal detachment (RD), of which 58.3% of patients had closed funnel retinal detachment. TSS was applied in nineteen patients and IOS in five patients. Postoperatively, a significant improvement on LogMAR BCVA was observed at each follow-up from 3.57 ± 0.69 before surgery to 2.82 ± 0.98 at the last follow-up (p < 0.05), and the proportion of no light perception (NLP) was also reduced from 69.6 to 37.5%. IOP was markedly elevated from 6.4 ± 4.1 mmHg preoperatively to 11.3 ± 4.3 mmHg at the last follow-up (p < 0.05). Choroidal reattachment was achieved in 91.7% of patients; two patients were observed with silicone oil migration at 3 months after surgery and underwent drainage of suprachoroidal silicone oil and sclera buckling. Meanwhile, retinal attachment was observed in 95.8% of patients, only one patient developed partial RD due to postoperative proliferative vitreoretinopathy, and secondary vitrectomy was performed; all patients were observed with complete retinal and choroidal attachment at the last follow-up. Eventually, four patients were silicone oil-free, and 20 patients were silicone oil-dependent.ConclusionsChoroidal suturing proved to be an effective method to fix the avulsed choroid, which greatly improved the BCVA and maintained the IOP, and efficiently increased the choroidal and retinal reattachment rate and preservation of the eyeball.

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Risk Factors for Post–Open-Globe Injury Endophthalmitis

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420932322 ◽

2020 ◽

Vol 4 (5) ◽

pp. 353-359

Author(s):

Aditya Uppuluri ◽

Marco A. Zarbin ◽

Neelakshi Bhagat

Keyword(s):

Risk Factors ◽

Univariate Analysis ◽

Binary Logistic Regression ◽

Clinical Findings ◽

National Inpatient Sample ◽

Open Globe Injury ◽

Adult Group ◽

Cross Sectional ◽

Increased Risk ◽

Open Globe

Purpose: The objective of our project is to use the National Inpatient Sample Database to identify risk factors for endophthalmitis in cases of open-globe injury (OGI). Methods: This is a cross-sectional observational study of 48 627 cases of OGI from the National Inpatient Sample Database. We performed regression analysis using IBM SPSS Statistics 23. Codes from the International Classification of Disease, Ninth Revision were used to identify ocular findings and conditions. Variables with P values less than .05 on univariate analysis were included in the multivariable regression model; Bonferroni correction was applied to these results. Results: Of the 48 627 cases of OGI, 37 440 (77.0%) occurred in the adult group (21 years and older). Overall, 1018 (2.1%) cases developed posttraumatic endophthalmitis, with 74.5% cases in the adult group. Endophthalmitis developed in 293 (4.5%) eyes with an intraocular foreign body (IOFB). Results of binary logistic regression showed the clinical findings of traumatic cataracts, hypopyon, vitreous inflammation, corneal ulcers, or IOFBs were associated with an increased risk of developing endophthalmitis after OGI. Conversely, orbital fractures, rupture-type injuries, and intraocular tissue prolapse were associated with a decreased likelihood of being diagnosed with endophthalmitis. Conclusions: Endophthalmitis developed in 2.4% of pediatric OGIs and 2.0% of adult OGIs. Traumatic cataract, hypopyon, vitreous inflammation, corneal ulcer, keratitis, retinal detachment, IOFB, and diabetes increased the risk of post-open-globe endophthalmitis.

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Incidence and risk factors for traumatic intraocular pressure elevation and traumatic glaucoma after open-globe injury

Eye ◽

10.1038/eye.2015.173 ◽

2015 ◽

Vol 29 (12) ◽

pp. 1579-1584 ◽

Cited By ~ 9

Author(s):

K D Bojikian ◽

A L Stein ◽

M A Slabaugh ◽

P P Chen

Keyword(s):

Risk Factors ◽

Intraocular Pressure ◽

Open Globe Injury ◽

Pressure Elevation ◽

Open Globe ◽

Intraocular Pressure Elevation

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Pediatric open-globe injury in a university-based tertiary hospital

European Journal of Ophthalmology ◽

10.1177/1120672118818013 ◽

2018 ◽

Vol 30 (2) ◽

pp. 269-274 ◽

Cited By ~ 2

Author(s):

Faisal AlDahash ◽

Ahmed Mousa ◽

Priscilla W Gikandi ◽

Ahmed M Abu El-Asrar

Keyword(s):

Visual Acuity ◽

Retinal Detachment ◽

Visual Outcome ◽

Tertiary Hospital ◽

Open Globe Injury ◽

Female Ratio ◽

Initial Visual Acuity ◽

Open Globe ◽

Type Of Injury

Background: To investigate epidemiology, etiology, and outcomes after repair of pediatric open-globe injury. Methods: We retrospectively reviewed medical records of patients ⩽18 years who underwent primary open-globe repair. Results: A total of 213 patients were identified. Male–female ratio was 1.44:1. Type of injury was penetration in 157 (74.4%) cases, rupture in 52 (24.4%) cases, and perforation in 2 (0.9%) cases. Knife injuries were the most common cause, affecting 38/196 (19.4%), followed by metallic object in 37/196 (18.9%) patients, glass in 26/196 (13.3%) patients, and pen or pencil in 24/196 (12.8%). Predictors of good visual outcome defined as (⩾20/40) were good initial visual acuity (⩾20/40; p < 0.0001), time from injury to arrival at the emergency room >24 h (p = 0.038), size of wound less than 10 mm (p < 0.0001), absence of iris prolapse (p < 0.0001), deep anterior chamber at presentation (p < 0.0001), absence of hyphema (p = 0.043), intact lens (p < 0.0001), and no retinal detachment during follow-up (p < 0.0001). A total of 27 (12.7%) cases were documented to have retinal detachment at any time during follow-up period. Predictors of retinal detachment were perforation and rupture (p < 0.0001), whereas penetration was not associated with development of retinal detachment, size of the wound ⩾10 mm (p < 0.0001), initial visual acuity ⩽20/200 (p < 0.0001), lens injury (p < 0.0001), and development of endophthalmitis (p < 0.027). Eight (3.7%) eyes had the clinical diagnosis of posttraumatic endophthalmitis. Conclusions: The most common type of injury was penetration and the most common tool was knife. Visual outcome was affected by the initial presentation. Retinal detachment was a significant predictor of a worse final visual outcome.

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Traumatic Pediatric Retinal Detachment following Open Globe Injury

Ophthalmologica ◽

10.1159/000101928 ◽

2007 ◽

Vol 221 (4) ◽

pp. 255-263 ◽

Cited By ~ 20

Author(s):

Nan-Kai Wang ◽

Yen-Po Chen ◽

Ling Yeung ◽

Kuan-Jen Chen ◽

An-Ning Chao ◽

...

Keyword(s):

Retinal Detachment ◽

Open Globe Injury ◽

Open Globe

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Validation of the Retinal Detachment after Open Globe Injury (RD-OGI) Score as an Effective Tool for Predicting Retinal Detachment

Ophthalmology ◽

10.1016/j.ophtha.2016.12.032 ◽

2017 ◽

Vol 124 (5) ◽

pp. 674-678 ◽

Cited By ~ 6

Author(s):

Katarzyna Brodowska ◽

Tomasz P. Stryjewski ◽

Evangelia Papavasileiou ◽

Yewlin E. Chee ◽

Dean Eliott

Keyword(s):

Retinal Detachment ◽

Open Globe Injury ◽

Open Globe

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Reliability of the ocular trauma score for the predictability of traumatic and post-traumatic retinal detachment after open globe injury

International Journal of Ophthalmology ◽

10.18240/ijo.2021.10.17 ◽

2021 ◽

Vol 14 (10) ◽

pp. 1589-1594

Author(s):

Simon Dulz ◽

◽

Toam Katz ◽

Robert Kromer ◽

Eileen Bigdon ◽

...

Keyword(s):

Retinal Detachment ◽

Ocular Trauma ◽

Vitreous Hemorrhage ◽

Open Globe Injury ◽

Ocular Trauma Score ◽

Open Globe ◽

Significant Difference ◽

Post Traumatic ◽

Trauma Score

AIM: To elucidate the question of whether the ocular trauma score (OTS) and the zones of injury could be used as a predictive model of traumatic and post traumatic retinal detachment (RD) in patients with open globe injury (OGI). METHODS: A retrospective observational chart analysis of OGI patients was performed. The collected variables consisted of age, date, gender, time of injury, time until repair, mechanism of injury, zone of injury, injury associated vitreous hemorrhage, trauma associated RD, post traumatic RD, aphakia at injury, periocular trauma and OTS in cases of OGI. RESULTS: Totally 102 patients with traumatic OGI with a minimum of 12mo follow-up and a median age at of 48.6y (range: 3-104y) were identified. Final best corrected visual acuity (BCVA) was independent from the time of repair, yet a statistically significant difference was present between the final BCVA and the zone of injury. Severe trauma presenting with an OTS score I (P<0.0001) or II (P<0.0001) revealed a significantly worse BCVA at last follow up when compared to the cohort with an OTS score >III. OGI associated RD was observed in 36/102 patients (35.3%), whereas post traumatic RD (defined as RD following 14d after OGI) occurred in 37 patients (36.3%). OGI associated RD did not correlate with the OTS and the zone of injury (P=0.193), yet post traumatic RD correlated significantly with zone III injuries (P=0.013). CONCLUSION: The study shows a significant association between lower OTS score and zone III injury with lower final BCVA and a higher number of surgeries, but only zone III could be significantly associated with a higher rate of RD.

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