scholarly journals A Possible Regression Equation for Predicting Visual Outcomes after Surgical Repair of Open Globe Injuries

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Huseyin Gursoy ◽  
Mustafa Deger Bilgec ◽  
Afsun Sahin ◽  
Ertugrul Colak
Keyword(s):  
Primary Repair ◽  
Linear Regression Analysis ◽  
Anterior Segment ◽  
Penetrating Injury ◽  
Time Interval ◽  
Visual Outcomes ◽  
Primary Surgery ◽  
Open Globe ◽  
Trauma Score ◽  
Open Globe Injuries

Background. To analyze the effects of factors other than the ocular trauma score parameters on visual outcomes in open globe injuries.Methods. Open globe injuries primarily repaired in our hospital were reviewed. The number of surgeries, performance of pars plana vitrectomy (PPV), lens status, affected tissues (corneal, scleral, or corneoscleral), intravitreal hemorrhage, intraocular foreign body, glaucoma, anterior segment inflammation, loss of iris tissue, cutting of any prolapsed vitreous in the primary surgery, penetrating injury, and the time interval between the trauma and repair were the thirteen variables evaluated using linear regression analysis.Results. In total, 131 eyes with a mean follow-up of16.1±4.7(12–36) months and a mean age of33.8±22.2(4–88) years were included. The regression coefficients were 0.502, 0.960, 0.831, −0.385, and −0.506 for the performance of PPV, aphakia after the initial trauma, loss of iris tissue, penetrating injury, and cutting of any prolapsed vitreous in the primary surgery, respectively (P<0.05for these variables).Conclusions. The performance of PPV, aphakia after the initial trauma, and loss of iris tissue were associated with poor visual outcomes, whereas cutting any prolapsed vitreous in the primary repair and penetrating-type injury were associated with better visual outcomes.

scholarly journals The Clinical Features and the Factors Affecting Visual Prognosis in Pediatric Open-Globe Injuries

2021 ◽  
Author(s):  
Hakan Öztürk ◽  
Bediz Özen
Keyword(s):  
Clinical Features ◽  
Good Prognosis ◽  
Penetrating Injury ◽  
Metal Object ◽  
Factors Affecting ◽  
Visual Prognosis ◽  
Globe Rupture ◽  
Open Globe ◽  
Trauma Score ◽  
Open Globe Injuries

Abstract Purpose: To investigate clinical features and factors affecting visual prognosis after pediatric open-globe injuries.Methods: Children with final logMAR-visual acuity (LVA)>0.70 were determined as poor-vision group (group1, n=108) and those with final LVA≤0.70 as good-vision group (group2, n=115). Analyzes were done. Results: Compared to group1, group2 had better initial and final visions (1.21±0.26 vs 0.60±0.28, p<0.001 for initial-LVA; 1.00±0.32 vs 0.30±0.13, p<0.001 for final-LVA), greater ocular trauma score (OTS) (1.72±0.53 vs 3.73±0.61, p=0.025) and smaller injury size (10.4±3.5 vs 5.8±2.4 mm, p=0.002). Globe rupture (37.0% vs 17.4%, p=0.015) and relative afferent pupillary defect (RAPD) (44.4% vs 17.3%, p=0.037) were higher in group1, while penetrating injury (45.4% vs 72.2%, p=0.044), zone 1 involvement (39.8% vs 65.2%, p=0.038) and metal object injury (29.6% vs 51.3%, p=0.041) were higher in group2. Final LVA (for group1 and group2) was negatively correlated with OTS (r=-0.398, p=0.037; r=-0.369, p=0.040), while positively correlated with injury size (r=0.412, p=0.031; r=0.318, p=0.046) and initial LVA (r=0.335, p=0.043; r=0.402, p=0.034). Conclusion: To our knowledge, this is the first study investigating effects of age, time between trauma and surgery, OTS, injury size, follow-up time and initial vision on final poor and good visions in detail. Low OTS, poor initial vision, globe rupture and RAPD were poor prognosis indicators, while small injury size, penetrating injury, zone 1 involvement and metal object injury were good prognosis indicators. Additionally, in both groups final vision worsened as OTS decreased, injury size increased, and initial vision worsened. These prognostic factors may be useful in managing trauma.

Wood-Related Open-Globe Injuries

2020 ◽  
pp. 247412642094662
Author(s):  
Tyler Pfister ◽  
Carisa Bohnak ◽  
Shriji Patel
Keyword(s):  
Medical Records ◽  
Vitreous Hemorrhage ◽  
Clinical Severity ◽  
Secondary Complications ◽  
Hand Motion ◽  
Visual Outcomes ◽  
Additional Surgery ◽  
Open Globe ◽  
Trauma Score ◽  
Open Globe Injuries

Purpose: This work evaluates the clinical characteristics, visual outcomes, and complications of patients treated for open-globe injuries (OGIs) caused by wooden objects. Methods: A retrospective review of medical records was conducted on patients presenting to a tertiary trauma center with an OGI between January 2005 and December 2017. Medical records were isolated for wounds caused by wooden objects. Patient demographics were recorded, with presenting visual acuity (VA), physical examination findings, and wound characteristics. After primary globe repair, secondary complications, need for additional surgery, and visual outcomes were noted until final examination. Main outcome measures were final VA and secondary complications. The Ocular Trauma Score (OTS) was computed and assessed for clinical relevance related to visual outcomes. Results: Thirty-two patients met the inclusion criteria, with 15 (47%) being injured by plant material. Thirty of the patients were men (94%). A large portion of patients presented with hand motion or worse vision (48%), and there were high rates of hyphema (59%), vitreous hemorrhage (31%), retinal detachment (28%), and endophthalmitis (9%). Two patients eventually required enucleation. At last follow-up, 19 patients achieved 20/100 VA or better (59.4%), which correlated with their OTS ( P < .001). Conclusions: Despite the high clinical severity of wood OGIs, the potential for visual recovery remains high. The OTS appropriately assesses the severity of injuries and the likely prognosis in this cohort of patients.

scholarly journals Factors Affecting Final Functional Outcomes in Open-Globe Injuries and Use of Ocular Trauma Score in Nepalese population

2020 ◽  
Author(s):  
Saurav Man Shrestha ◽  
Casey Leigh Anthony ◽  
Justin A. Grant ◽  
Madhu Thapa ◽  
Jyoti Baba Shrestha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Final Visual Acuity ◽  
Delayed Presentation ◽  
Ocular Trauma Score ◽  
Visual Outcomes ◽  
Open Globe ◽  
The Mean ◽  
Trauma Score ◽  
Open Globe Injuries

Abstract Background: Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods: Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results: Seventy-three eyes of 72 patients were examined. 76% were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was <6 hours (30 patients, 41%). Thirty-seven eyes (51%) had zone I trauma, followed by twenty eyes (27%) with zone II, and sixteen eyes (22%) with zone III trauma. Sixty-five patients (90%) were managed surgically, and fifty (68%) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60% of the eyes with OGI of various zones (p<0.05). Conclusion: OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.

scholarly journals Effect of time to primary repair on final visual outcome after open globe injury

2019 ◽  
Vol 103 (10) ◽  
pp. 1491-1494 ◽  
Author(s):  
Richard J Blanch ◽  
Jonathan Bishop ◽  
Hedayat Javidi ◽  
Philip Ian Murray
Keyword(s):  
Visual Acuity ◽  
Primary Repair ◽  
Demographic Data ◽  
Case Series ◽  
Visual Outcome ◽  
Final Visual Acuity ◽  
Visual Outcomes ◽  
Open Globe ◽  
Final Visual Outcome ◽  
Open Globe Injuries

Background/AimHistoric data suggest that open globe injuries should be repaired within 12–24 hours to reduce the risk of endophthalmitis. However, endophthalmitis is uncommon when systemic antibiotic prophylaxis is given. It is not clear whether delayed primary repair impacts visual outcomes in other ways or what is the optimum time to repair. We aimed to examine the effect of time to primary repair on visual outcomes.MethodsThis is a retrospective comparative case series including all open globe injuries presenting to the Birmingham Midland Eye Centre between 1 January 2014 and 15 March 2016. Presenting features, mechanism of injury, visual acuity at 6–12 months and demographic data were examined.Results56 open globe injuries were repaired, of which sufficient data for analysis were available on 52 cases. The mean time to primary repair was 1 day after injury (range 5 hours to 7 days). Final visual acuity at 6–12 months was related to the presenting visual acuity and the Ocular Trauma Score and to the time between injury and primary repair, with a reduction in predicted visual acuity of logarithm of the minimum angle of resolution of 0.37 for every 24 hours of delay (95% CI 0.14 to 0.6).DiscussionOpen globe injuries should be repaired promptly. Presenting visual acuity remains the strongest predictor of outcome; however, delay to primary repair also reduced final visual acuity, and any significant delay from injury to repair is likely to negatively impact final visual outcome.

scholarly journals Factors affecting final functional outcomes in open‐globe injuries and use of ocular trauma score as a predictive tool in Nepalese population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saurav M. Shrestha ◽  
Casey L. Anthony ◽  
Grant A. Justin ◽  
Madhu Thapa ◽  
Jyoti B. Shrestha ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Ocular Trauma ◽  
Final Visual Acuity ◽  
Predictive Tool ◽  
Ocular Trauma Score ◽  
Visual Outcomes ◽  
Open Globe ◽  
The Mean ◽  
Trauma Score ◽  
Open Globe Injuries

Abstract Background Open globe injury (OGI) is one of the most devastating form of ocular trauma. The aim of the study is to identify the epidemiology and predict visual outcomes in traumatic open globe injuries using ocular trauma score (OTS) and correlate with final visual acuity (VA) at 3 months. Methods Patients older than 5 years, presenting to B.P. Koirala Lions Centre for Ophthalmic Studies (BPKLCOS) from March 2016- March 2017 with OGI that met inclusion criteria were evaluated. Patient profile, nature and cause of injury, and time to presentation were recorded. Patients were managed accordingly and followed up to 3 months. An OTS score for each patient was calculated and raw scores were categorized accordingly. The VA after 3 months were compared to the predicted OTS values. Results Seventy-three eyes of 72 patients were examined. 76 % were male, and the mean age was 26.17 years (median, 23.5 years). The mean time from injury to presentation was < 6 hours (30 patients, 41 %). Thirty-seven eyes (51 %) had zone I trauma, followed by twenty eyes (27 %) with zone II, and sixteen eyes (22 %) with zone III trauma. Sixty-five patients (90 %) were managed surgically, and fifty (68 %) received intravitreal antibiotics with steroid. When compared, the projected VA as per OTS were able to predict actual final visual outcomes in 60 % of the eyes with OGI of various zones. Conclusions OTS can be an accurate predictive tool for final visual acuity even with a short follow up period of 3 months; with poor presenting visual acuity, delayed presentation, posterior zones of injury, need for intravitreal injections, endophthalmitis, and globe rupture associated with poorer prognosis.

Visual Outcomes and Mechanism of Open-Globe Injuries with No Light Perception

2020 ◽  
Author(s):  
Shohei Morikawa ◽  
Fumiki Okamoto ◽  
Yoshifumi Okamoto ◽  
Yoshinori Mitamura ◽  
Hiroto Ishikawa ◽  
...  
Keyword(s):  
Light Perception ◽  
Visual Outcomes ◽  
Open Globe ◽  
Open Globe Injuries

scholarly journals The Impact of Primary Treatment on Post-Traumatic Endophthalmitis in Children with Open Globe Injuries: A Study in China

2019 ◽  
Vol 16 (16) ◽  
pp. 2956 ◽  
Author(s):  
Lingling Zheng ◽  
Junlian Tan ◽  
Rongjiao Liu ◽  
Xueru Yang ◽  
Huiling He ◽  
...  
Keyword(s):  
Rural Areas ◽  
Primary Repair ◽  
Univariate Analysis ◽  
Primary Treatment ◽  
Delayed Treatment ◽  
Left Behind ◽  
Open Globe ◽  
Post Traumatic ◽  
The Impact ◽  
Open Globe Injuries

Post-traumatic endophthalmitis (PTE) is considered as one of the most serious complications after open globe injuries (OGIs), especially in children. Poor prognosis of this disease can lead to a variety of socioeconomic problems. This study aimed to investigate the clinical characteristics of pediatric OGIs and the factors associated with the development of PTE in China. 131 patients under 14 years old and needed hospitalization for management of OGIs were enrolled. There were 90 males and 41 females. 44 patients were left-behind children, the majority were 3–6 years old (n = 71, 71/131, 54.2%) and living in rural area (n = 106, 106/131, 80.9%). After injury, 82 patients received primary repair within 24 h, with the remaining 49 patients receiving primary repair after 24 h. Eventually, there were 28 (28/131, 21.4%) patients presented with PTE. In those 49 patients, the frequency of PTE achieving 32.7% (16/49). Univariate analysis showed that the timing of primary repair is significantly associated with the development of PTE (p < 0.05). Moreover, left-behind children took higher risks in having delayed treatment that over 24 h after OGIs (OR = 2.466, 95% CI: 1.16–5.26). Reducing the time before primary repair is a useful strategy to prevent the development of PTE. Special supervision is needed for pre-school-aged boys living in rural areas, especially for left-behind children.

scholarly journals Open-Globe Injury With Intraocular Foreign Body

2020 ◽  
pp. 247412642096503
Author(s):  
Filippos Vingopoulos ◽  
Yvonne Wang ◽  
Seanna Grob ◽  
Chloe Yang Ling Li ◽  
Dean Eliott ◽  
...  
Keyword(s):  
Foreign Body ◽  
Primary Repair ◽  
Anterior Segment ◽  
Case Series ◽  
Visual Outcome ◽  
Posterior Segment ◽  
Open Globe ◽  
Time From Injury

Purpose: To investigate characteristics of Open Globe Injuries (OGI) that presented with Intra-Ocular Foreign Body (IOFB), along with their long-term visual outcomes and complications. Methods: Retrospective interventional consecutive case series of OGIs with IOFBs that presented at Massachusetts Eye and Ear from 2010 to 2015. Data collected included time from injury to OGI repair, location of IOFB, retinal detachment (RD) rate, presenting and final visual acuity and subsequent surgeries. Results: Fifty-seven consecutive cases of OGIs with IOFBs were included. Mean follow-up was 28 months and median time from injury to OGI repair was 0 days. Overall, 38/57 (66.7%) eyes achieved final vision of 20/40 or better and 43/57 (75.4%) 20/150 or better. Thirty-three cases had IOFBs in the anterior segment only, 24 cases had posterior segment involvement. Thirty percent of cases (17/57) were complicated by an RD, 58.3% (14/24) in the posterior versus 9.1% (3/33) in the anterior IOFB group ( P = .01). There were no cases of endophthalmitis. Posterior IOFB and higher zone of injury were risk factors for RD both at presentation (both P < .001) and post-primary repair (both P < .001). Posterior IOFB was associated with higher vitrectomy rates both at presentation ( P < .001) and post-primary repair ( P = .002) and worse long-term visual outcome ( P = .01). Conclusions: OGIs with IOFB involving the posterior segment are associated with higher complication and re-operation rates and worse visual prognosis compared to those involving the anterior segment only.

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