Zhi Hong Toh1, Shreya Mehul Shah2, Chun Hau Chua1, Annette K Hoskin3,4, Rupesh Agrawal5,6,7,8, Mehul Shah9. 1. National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore. 2. Drashti Netralaya Ophthalmic Mission Trust, Dahod, Gujarat, India. 3. Save Sight Institute, University of Sydney, Sydney, Australia. 4. Lions Eye Institute, University of Western Australia, Perth, WA, Australia. 5. National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore, Singapore. rupeshttsh@gmail.com. 6. Singapore Eye Research Institute, Singapore, Singapore. rupeshttsh@gmail.com. 7. Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. rupeshttsh@gmail.com. 8. Duke NUS Medical School, Singapore, Singapore. rupeshttsh@gmail.com. 9. Drashti Netralaya Ophthalmic Mission Trust, Dahod, Gujarat, India. omtrustdahod@gmail.com.
Abstract
BACKGROUND/ OBJECTIVES: To evaluate the factors influencing final visual outcome after surgical repair of open globe injuries (OGIs) in a rural population using the International Globe and Adnexal Trauma Epidemiology Study (IGATES) online registry. SUBJECTS/ METHODS: Retrospective cohort study of patients with OGI. OGIs were identified from the IGATES database at a tertiary referral eye care centre in rural West India over a period of 12 years. Patient demographics, clinical and pre-operative factors affecting final visual outcome was evaluated. RESULTS: A total of 791 eyes with OGIs were included in data analysis. 11 eyes that were lost to follow-up and 12 eyes with incomplete data were excluded. Most of the patients were male (559, 70.6%) and mean age of all patients was 23.9 years ± 19.4 years. Occupational hazards (including domestic housework) (307, 38.8%) and leisure play (324, 41.0%) were the leading causes of OGI. The most common mechanism of injury was being struck by a wooden stick (250, 31.6%). Univariate analysis of pre-operative variables showed initial visual acuity (VA), zone of injury, size of wound, structures involved in the injury and presence of infection were significant prognostic factors for worse final visual outcome (p < 0.001). Multivariate analysis showed VA ≤ 3/60 or worse at presentation had statistically significantly higher odds ratio of ending up with worse visual outcomes (p < 0.012). CONCLUSIONS: Males in working age groups suffer from OGIs more frequently, usually from agricultural and pastoral activities. Initial VA, zone 3 injuries, corneoscleral wound, large wound size and presence of post-traumatic infections are significant prognostic factors.
BACKGROUND/ OBJECTIVES: To evaluate the factors influencing final visual outcome after surgical repair of open globe injuries (OGIs) in a rural population using the International Globe and Adnexal Trauma Epidemiology Study (IGATES) online registry. SUBJECTS/ METHODS: Retrospective cohort study of patients with OGI. OGIs were identified from the IGATES database at a tertiary referral eye care centre in rural West India over a period of 12 years. Patient demographics, clinical and pre-operative factors affecting final visual outcome was evaluated. RESULTS: A total of 791 eyes with OGIs were included in data analysis. 11 eyes that were lost to follow-up and 12 eyes with incomplete data were excluded. Most of the patients were male (559, 70.6%) and mean age of all patients was 23.9 years ± 19.4 years. Occupational hazards (including domestic housework) (307, 38.8%) and leisure play (324, 41.0%) were the leading causes of OGI. The most common mechanism of injury was being struck by a wooden stick (250, 31.6%). Univariate analysis of pre-operative variables showed initial visual acuity (VA), zone of injury, size of wound, structures involved in the injury and presence of infection were significant prognostic factors for worse final visual outcome (p < 0.001). Multivariate analysis showed VA ≤ 3/60 or worse at presentation had statistically significantly higher odds ratio of ending up with worse visual outcomes (p < 0.012). CONCLUSIONS: Males in working age groups suffer from OGIs more frequently, usually from agricultural and pastoral activities. Initial VA, zone 3 injuries, corneoscleral wound, large wound size and presence of post-traumatic infections are significant prognostic factors.
Authors: Sannapaneni Krishnaiah; Praveen K Nirmalan; Bindiganavale R Shamanna; Marmamula Srinivas; Gullapalli N Rao; Ravi Thomas Journal: Ophthalmology Date: 2006-07 Impact factor: 12.079
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