Risk factors for poor outcomes in patients with open-globe injuries

Area of Science:

• Ophthalmology
• Trauma Surgery
• Vision Science

Background:

• Penetrating globe trauma is a significant cause of vision loss.
• Identifying predictive risk factors is crucial for managing these injuries and improving patient outcomes.

Purpose of the Study:

• To identify risk factors that predict poor outcomes in patients with penetrating globe trauma.
• To analyze the association between preoperative visual acuity, ocular trauma score, zone of injury, and time to repair with final visual outcomes.

Main Methods:

• Retrospective case series of 64 eyes surgically treated for open-globe injury.
• Analysis of 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 repair.
• Outcomes assessed included final BCVA, monthly rate of additional surgeries (MRAS), and enucleation.

Main Results:

• Pre-op BCVA was positively associated with MRAS and final BCVA.
• Calculated OTS was negatively associated with final BCVA.
• No significant association was found between TL or ZOI and the outcome variables.
• Adjusted analyses confirmed pre-op BCVA's independent positive association with MRAS and final BCVA, and OTS's independent negative association with final BCVA.

Conclusions:

• Preoperative best-corrected visual acuity and ocular trauma score are key indicators for prognosis in open-globe injuries.
• While these factors show correlation, no single conventional feature reliably predicts the outcome for all traumatized eyes.