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

Gürsoy, Hüseyin; Bilgeç, Mustafa Değer; Şahin, Afsun; Çolak, Ertuğrul

doi:10.1155/2017/1320457

Cited by 9 publications

(6 citation statements)

References 26 publications

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“…Ten patients were treated for suspected endophthalmitis, giving a rate of 2.6%. This is comparable to other studies ranging from 1% to 2% 11,23,37 to 12%. 38 Being a child (50% of cases) and having an IOFB (40% of cases) seemed to carry the greatest risk although total numbers were small.…”

Section: Discussionsupporting

confidence: 91%

Visual and ocular morbidity in severe open‐globe injuries presenting to a regional eye centre in New Zealand

Court

Wang

et al. 2018

Clinical Exper Ophthalmology

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Importance Open‐globe injuries (OGI) are a leading cause of monocular blindness world‐wide with considerable cost to the individual and society. Background To characterize the epidemiology, severity and outcomes of OGI treated at a major ophthalmology centre in New Zealand. Design Retrospective study. Participants A total of 385 eyes of 381 patients over a 10‐year period. Methods Eligible patients were identified using diagnosis and surgery codes on hospital discharge summaries. Clinical notes were reviewed to determine patient demographics, injury details, treatments and outcomes. Main Outcome Measures Complications of injury, visual acuity at 3 months and final follow‐up, and final status of the eye. Results The estimated annual incidence of OGI was 2.8 per 100 000. Working‐age males predominated but age at injury ranged from 9 months to 90 years. Maori and Pacific peoples were over‐represented. Injuries were severe with 58.7% presenting with vision of hand movements or worse. Penetrating injuries (56.4%) were most common, followed by globe ruptures (35.6%). Major complications included retinal detachment (15.8%), enucleation/evisceration (9.1%), phthisis bulbi (9.9%), endophthalmitis (2.6%) and sympathetic ophthalmia (0.26%). Despite the injury severity, 46% of eyes achieved final BCVA of ≥6/12. The Ocular Trauma Score (OTS) was a useful prognostic tool for stratifying severity of injury and predicting visual outcome (Fisher's exact test P < 0.001). Conclusions and Relevance The incidence and severity of OGI in NZ are comparable to global statistics. Surgical repair can effectively recover vision, predicted well by the OTS. We identified at‐risk groups to target with education and prevention strategies.

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Section: Discussionsupporting

confidence: 91%

Visual and ocular morbidity in severe open‐globe injuries presenting to a regional eye centre in New Zealand

Court

Wang

et al. 2018

Clinical Exper Ophthalmology

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“…Ocular morbidity included corneal laceration in all cases and uveal involvement in 5 of 9 cases, which is known to portend poor long-term visual recovery. 14 Three of 9 patients had retinal detachments necessitating further surgery.…”

Section: Discussionmentioning

confidence: 97%

“…Seven of 9 cases involved the driver and 8 of 9 involved the eye on the same side as the shattered sideview mirror (1 case did not report vehicle laterality). Ocular morbidity included corneal laceration in all cases and uveal involvement in 5 of 9 cases, which is known to portend poor long-term visual recovery . Three of 9 patients had retinal detachments necessitating further surgery.…”

Section: Discussionmentioning

confidence: 99%

Motor Vehicle–Associated Traumatic Ocular Injuries Secondary to External Rear-Facing Sideview Mirrors

et al. 2019

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IMPORTANCE Rear-facing sideview mirrors are a potentially reducible source of ocular morbidity following motor vehicle crashes.OBJECTIVE To report cases highlighting shattered glass from sideview mirrors as a potential cause of ocular trauma in motor vehicle crashes.DESIGN, SETTING, AND PARTICIPANTS Case series of 3 patients who presented to Grady Memorial Hospital, a level 1 trauma center and tertiary hospital, between May 5, 2017, and July 10, 2017, with ocular trauma as a result of shattered glass from sideview mirrors during motor vehicle crashes. A review of the literature was also conducted. Data were analyzed between July 2017 and August 2017. INTERVENTIONS OR EXPOSURES Operation for exploration and repair of open globe in all 3 cases. MAIN OUTCOMES AND MEASURES Visual prognosis and ocular morbidity postoperatively.RESULTS All patients were white men in the age range of 26 to 43 years. This was a retrospective review of 3 of 208 patients who presented to Grady Memorial Hospital after motor vehicle crashes from May 5, 2017, to July 10, 2017. From the time of presentation of the 3 reported patients from Grady Memorial Hospital, all 3 had 2 surgeries inclusive of the initial open globe repair. Patients with this mechanism of injury experienced ocular morbidity, with all 3 cases resulting in uveal prolapse and 2 of 3 resulting in retinal detachments. Among the 3 patients, visual acuities after the second surgery within the first year were hand motion, 20/100, and 20/150.CONCLUSIONS AND RELEVANCE Sideview mirrors can be a cause of serious ocular injuries in motor vehicle crashes. These 3 reported cases, combined with cases previously reported, suggest that this mechanism of ocular injury does occur. Further studies seem warranted to investigate the frequency of these findings and whether any design modifications may help reduce the frequency.

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“…4 shows that after three surgeries, patients have no further improvement and reach a plateau vision of about 2 logMAR, which equals hand motion. Gursoy et al found that number of surgeries did not have a significant effect on final BCVA [36]. Therefore, surgical procedures should be considered especially with regard to patient age, condition and risk of general anesthesia.…”

Section: Therapymentioning

confidence: 99%

Traumatic open globe injury—epidemiology, risk factors and visual outcome at the University Hospital Aachen

Djalali-Talab

Mazinani

Djalali-Talab

2021

Spektrum Augenheilkd.

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Summary Background Ocular trauma is still a major cause leading to enucleation. This study aims to analyze the visual outcome, epidemiology and risk factors of open globe injury (OGI) at the University Hospital Aachen, Germany. Material and methods A retrospective analysis of patient records involving traumatic OGI treated surgically between 2005 and 2015 was conducted. Age, gender, cause of accident, ocular trauma score, best corrected visual acuity (BCVA) at presentation and after treatment as well as location of injury were evaluated. Results Of 2272 eyes with trauma, 102 patients with OGI were identified, of which 65% were male and 35% were female. Women were significantly older than men (p < 0.001). The most common cause of injury was domestic syncopal episodes (47%). Work-related injuries occurred exclusively in men in 8.8%. A total of 16% had no light perception (NLP) at presentation, 69% of which improved post intervention to hand movement or better. Endophthalmitis was observed in 4% of all cases. Enucleation was needed mostly due to rupture. Location of OGI, pseudophakia and initial BCVA are risk factors for poor final BCVA. Patients’ BCVA did not improve further after three surgeries. Conclusion Traumatic OGI still poses a challenge in terms of treatment planning and prognostic outcome. A rise in elderly patients with multimorbidity represents a secondary obstacle to treatment. Patients with initial NLP can be treated with moderate success. Nevertheless, risk factors and ocular trauma score are unable to provide definitive therapy decisions. OGI should be assessed case by case, taking risk factors for OGI into account. Treating physicians should consider the ethical and economic reasons with regard to whether a high number of surgeries with possible comorbidities is justified.

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

Cited by 9 publications

References 26 publications

Visual and ocular morbidity in severe open‐globe injuries presenting to a regional eye centre in New Zealand

Visual and ocular morbidity in severe open‐globe injuries presenting to a regional eye centre in New Zealand

Motor Vehicle–Associated Traumatic Ocular Injuries Secondary to External Rear-Facing Sideview Mirrors

Traumatic open globe injury—epidemiology, risk factors and visual outcome at the University Hospital Aachen

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