Risk factors for poor outcomes in patients with open-globe injuries
Authors Page RD, Gupta S, Jenkins T, Karcioglu Z
Received 21 March 2016
Accepted for publication 4 May 2016
Published 1 August 2016 Volume 2016:10 Pages 1461—1466
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Rita D Page,1 Sumeet K Gupta,1 Thomas L Jenkins,1 Zeynel A Karcioglu1,2
1Department of Ophthalmology, 2Department of Pathology, University of Virginia, Charlottesville, VA, USA
Purpose: The aim of this study was to identify the risk factors that are predictive of poor outcomes in penetrating globe trauma.
Patients and methods: This retrospective case series evaluated 103 eyes that had been surgically treated for an open-globe injury from 2007 to 2010 at the eye clinic of the University of Virginia. A total of 64 eyes with complete medical records and at least 6 months of follow-up were included in the study. Four risk factors (preoperative best-corrected visual acuity [pre-op BCVA], ocular trauma score [OTS], zone of injury [ZOI], and time lapse [TL] between injury and primary repair) and three outcomes (final BCVA, monthly rate of additional surgeries [MRAS], and enucleation) were identified for analysis.
Results: Pre-op BCVA was positively associated with MRAS, final BCVA, and enucleation. Calculated OTS was negatively associated with the outcome variables. No association was found between TL and ZOI with the outcome variables. Further, age and predictor variable-adjusted analyses showed pre-op BCVA to be independently positively associated with MRAS (P=0.008) and with final BCVA (P<0.001), while the calculated OTS was independently negatively associated with final BCVA (P<0.001), but not uniquely associated with MRAS (P=0.530).
Conclusion: Pre-op BCVA and OTS are best correlated with prognosis in open-globe injuries. However, no conventional features reliably predict the outcome of traumatized eyes.
Keywords: penetrating globe trauma, eye injuries, prognostic factors, predictors, visual outcome, ocular trauma score