Retinal Detachment After Open-globe Injury

Abstract

Open-globe injuries are a major cause of vision loss worldwide, with over 200,000 such injuries occurring each year. 1 Defined as any fullthickness wound of the eye wall, open-globe injuries can result in significant damage to the anterior and posterior segments of the eye and necessitate multiple surgical interventions over the course of years. 2,3 Although visual outcomes with surgical repair of open globes have improved over the past several decades, many severely damaged eyes continue to have poor visual potential. 4 Multiple predictors of visual outcome after open-globe injury have been identified, including the presence of relative afferent pupillary defect, preoperative visual acuity (VA), mechanism of injury, location of rupture site, and retinal detachment. [5][6][7][8][9][10][11][12][13][14][15][16] Many studies have demonstrated that retinal detachment both at the time of initial presentation and in the postoperative course after open-globe repair is associated with poor vision, phthisis, and enucleation. 3,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] This review will examine the pathogenesis, incidence, predictors, repair, possible prophylaxis, and prognosis of retinal detachments after open-globe injuries. ' PathogenesisAny disruption of the normal mechanical and metabolic forces of adhesion between the neurosensory retina and the underlying retinal pigment epithelium will result in a retinal detachment. 26 Open-globe injuries can be categorized into 3 zones by wound location; zone 1 and 2 injuries are more anterior, whereas zone 3 injuries are posterior to the anterior 5 mm of sclera and therefore consist of scleral wounds overlying

Effect of Time to Operative Repair Within Twenty-Four Hours on Visual Acuity Outcomes for Open Globe Injuries

“…This is consistent with prior literature where many of these factors were found to in uence nal visual acuity and were included in the Ocular Trauma Score, which can be used to prognosticate nal visual acuity. 2,3,4,5,6,7,8,20 Notably, in our study, presence of rAPD was the strongest predictor of poor nal visual acuity, followed by rupture as a mechanism of injury. Mechanism of injury was also highly correlated with visual outcomes, with only 8.6% of laceration injuries resulting in LP or worse vision, versus 38% of rupture injuries resulting in LP or worse vision.…”

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

“…Injuries with sharp objects can cause less ocular damage as they can occur with lower energy. On the other hand, injuries with blunt objects can cause more severe ocular damage such as globe rupture, as they can require higher energy [21,27,28]. The visual prognosis was determined to be better in injuries with sharp objects [1].…”

Successful Management in a Case of Traumatic Retinal Detachment due to Open Globe Injury Using Microincisional Vitrectomy

“…Open globe injuries with RD belong to a particular subgroup expected to have an even worse prognosis than those involving the posterior segment without RD. The incidence of traumatic RD at presentation or within 24 h after repair ranged from 2.5 to 39.9% [2]. Attempts at predicting the risk of RD have ben made.…”