Open-globe injuries at an emergency department in Porto, Portugal: clinical features and prognostic factors

Eur J Ophthalmol. 2014 Nov-Dec;24(6):932-9. doi: 10.5301/ejo.5000471. Epub 2014 Apr 16.

Abstract

Purpose: To describe the epidemiology, characteristics, surgical management, functional outcome, and prognostic factors of open-globe injuries requiring surgical treatment.

Methods: A retrospective review of 180 patients who underwent surgical repair of an open-globe injury at the ophthalmology emergency department of the Hospital S. João (Porto-Portugal) was performed. Prognostic factors for no light perception and for poor vision (visual acuity <3/10) in patients who retained vision after surgical treatment were determined.

Results: We observed a different age distribution between male and female ocular trauma (143 patients were men, with a mean age of 46.4 years, while the mean age for women was 70.9 years). Domestic accidents were the most frequent context of trauma (44.4%). However, work accidents constituted the principal context of trauma among men. Initial visual acuity, concomitant adnexa lesion, associated nonocular trauma, and intentionally caused trauma were predictors of no vision at the end of the follow-up. Older age, lens damage, and retinal detachment were predictors of poor vision in patients with retained visual acuity. Vitreous hemorrhage, posterior segment lesion, and simultaneous lesion of anterior and posterior segment anticipated both no vision and poor vision. Isolated anterior segment lesion was associated with vision survival and good vision (≥3/10).

Conclusions: The prognostic factors identified in this study may aid the process of decision-making in 2 crucial moments: at the initial approach and during the follow-up of patients with vision survival after open-globe injuries.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data
  • Eye Injuries, Penetrating / diagnosis*
  • Eye Injuries, Penetrating / epidemiology*
  • Eye Injuries, Penetrating / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures
  • Portugal / epidemiology
  • Prognosis
  • Retinal Detachment / complications
  • Retrospective Studies
  • Visual Acuity / physiology
  • Vitreous Hemorrhage
  • Young Adult