Open globe injuries: Prognostic factors and functional outcomes

Session Details

Session Title: Free Paper Session 15: Mixed Session

Session Date/Time: Friday 08/09/2017 | 16:30-18:00

Paper Time: 17:12

Venue: Room 117

First Author: : H.Arda GERMANY

Co Author(s): :    I. Nagel   M. Schaumberger   C. Miller   A. Kampik   S. Priglinger   A. Wolf              

Abstract Details

Purpose:

To analyse the characteristics of patients with open globe injury (OGI) in a large German tertiary referral centre and to evaluate functional outcome and previously described prognostic factors in eyes of patients with OGI in a current period of time.

Setting:

Retrospective chart review of 222 consecutive patients in total who presented with OGI and were primarily treated at the LMU University Eye Hospital Munich between June 2008 and October 2013.

Methods:

The medical records of all patients with OGI were evaluated to determine the functional outcome and prognostic factors. Additionally, other factors were analysed such as no light perception (NLP) at presentation, the context of trauma or characteristic complications. The classification of OGI was based on the Birmingham Eye Trauma Terminology (BETT) and clinical parameters were summarized as defined by the Ocular Trauma Score (OTS).

Results:

The mean age of 222 patients was 42 years ± 23.99 SD (SD=standard deviation). 80.2% were male and 19.2% female. Work-related (38.7%) or domestic accidents (25.7%) were the most frequent context of trauma. 70.7% of the accidents were caused by a sharp object and metal was the most common material (38.7%). 13.5% of the injuries were fall-related. Mean follow-up was 85.5 days (range 0-2526d). On average, patients presented with an OTS-category of 2.5 ± 0,821 SD. The most common mechanism of injury was penetrating trauma (n=131) and 59 presented with intraocular foreign body (IOFB). Even an improvement of OTS by 1 led to a significantly better functional outcome (p<0.001). Clinical features that resulted in bad functional outcome were poor visual acuity (VA) at presentation (p<0.001), increasing interval between trauma and surgical treatment (p=0.009) and vitreous haemhorrage during follow-up (p=0.011). Most frequent postoperative complications were traumatic cataract (38.7%), choroidal detachment (20.3%), vitreous haemhorrage (18%) and retinal detachment (14.4.%). Endophthalmitis occurred in 2.7% after 16 days on average (range 2–52d) and 50% of these had an IOFB. Initial NLP showed a reduced outcome (p<0,001). However, 40% of patients with NLP initially had a final VA of hand movement or better.

Conclusions:

The importance of the classification by BETT and its prospective significance in a more current collective of patients with OGI could be demonstrated. While NLP at presentation showed an increase of VA in 40% of cases, new operative procedures don’t seem to affect the prognosis of the OTS.

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