Zone 1 trauma: wound dehiscence compared to primary trauma

Area of Science:

• Ophthalmology
• Trauma Surgery

Background:

• Open globe injuries require prompt surgical repair.
• Zone 1 injuries are typically considered to have a better prognosis.
• The impact of wound dehiscence versus primary trauma on outcomes is not fully elucidated.

Purpose of the Study:

• To compare the prognosis of Zone 1 open globe injuries resulting from wound dehiscence versus primary trauma.
• To identify factors influencing visual outcomes and complications in Zone 1 open globe injuries.

Main Methods:

• Retrospective chart review of patients undergoing open globe repair.
• Inclusion criteria: urban hospital setting, 1/1/2019 to 12/1/2020.
• Evaluation of final visual outcomes, ocular pathology, complications, and re-operation rates.

Main Results:

• Fifty-eight eyes analyzed: 38 primary trauma, 20 dehisced wounds.
• Dehisced wounds showed higher rates of posterior segment pathology, vitreous/uveal prolapse, and traumatic aphakia.
• Worse visual outcomes in dehisced wounds, including higher enucleation rates and no light perception (NLP).

Conclusions:

• Zone 1 open globe injuries from wound dehiscence have a poorer prognosis than primary traumatic injuries.
• The source of the injury (dehiscence vs. primary trauma) is a more significant prognostic factor than the injury zone.
• This highlights the need for tailored management strategies based on injury etiology.