Manoj M Thakker1, Subhransu Ray. 1. Department of Ophthalmology, University of Washington, Seattle, WA 98195, USA. mthakker@u.washington.edu
Abstract
BACKGROUND: To correlate vision-limiting complications of open-globe trauma with anatomical zone and mechanism of injury. METHODS: Retrospective review of 235 patients with open-globe injuries at the Massachusetts Eye and Ear Infirmary. Vision-limiting complications were assessed at 2 to 3 months after the injury. RESULTS: Traumatic cataracts and corneal scarring were the most prevalent vision-limiting complications in patients with zone I (cornea-only) lacerations. The most common vision-limiting factors in eyes with zones II and III lacerations (involving sclera) were cataracts and retinal detachments. In patients with penetrating injuries, predominant vision-limiting findings were traumatic cataracts and corneal scarring. In patients with blunt-force ruptures, leading causes were traumatic cataracts and retinal detachments. There were increased rates of phthisis and enucleation surgery in patients with ruptures and zones II and III injuries. In cases of penetrating and zone I injuries, significantly more patients achieved visual acuities better than 20/50 when compared with eyes that had ruptures or zones II and III injuries. INTERPRETATION: Traumatic cataracts were the most common vision-limiting factor in all subcategories of open-globe injuries. Injuries in zones II and III and blunt-force ruptures were associated with increased rates of retinal detachments, phthisis, and enucleation, contributing to the poorer visual prognosis in these patients.
BACKGROUND: To correlate vision-limiting complications of open-globe trauma with anatomical zone and mechanism of injury. METHODS: Retrospective review of 235 patients with open-globe injuries at the Massachusetts Eye and Ear Infirmary. Vision-limiting complications were assessed at 2 to 3 months after the injury. RESULTS:Traumatic cataracts and corneal scarring were the most prevalent vision-limiting complications in patients with zone I (cornea-only) lacerations. The most common vision-limiting factors in eyes with zones II and III lacerations (involving sclera) were cataracts and retinal detachments. In patients with penetrating injuries, predominant vision-limiting findings were traumatic cataracts and corneal scarring. In patients with blunt-force ruptures, leading causes were traumatic cataracts and retinal detachments. There were increased rates of phthisis and enucleation surgery in patients with ruptures and zones II and III injuries. In cases of penetrating and zone I injuries, significantly more patients achieved visual acuities better than 20/50 when compared with eyes that had ruptures or zones II and III injuries. INTERPRETATION:Traumatic cataracts were the most common vision-limiting factor in all subcategories of open-globe injuries. Injuries in zones II and III and blunt-force ruptures were associated with increased rates of retinal detachments, phthisis, and enucleation, contributing to the poorer visual prognosis in these patients.