Increased risk of sympathetic ophthalmia in ocular surgical patients with trauma history

To determine the risk of sympathetic ophthalmia (SO) among ocular surgery patients with and without a history of ocular trauma.

This cohort study used the multi-institutional TriNetX platform to enroll ocular surgery patients with and without a history of ocular trauma from January 1, 2005, to December 31, 2023. The primary outcome was the risk of developing SO in the ocular trauma group compared to those without.

A total of 16,198 patients who underwent ocular surgery with prior ocular trauma (mean [SD] age, 45.59 [23.26] years; 28.58% female) and 16,198 without trauma history (46.49 [25.13] years; 28.74% female) were included. Patients with prior trauma had a higher risk of SO, with increased risk evident from 3 months after the index date (HR, 13.45; 95% CI, 1.77-102.20) and persisting through 18 years (7.21; 2.83-18.37). Stratified analyses showed elevated risk after anterior segment surgery (21.62; 2.91-160.40) and vitreoretinal surgery (5.84; 1.31-26.08). Increased risk was also observed for both closed globe injury (21.97; 2.96-163.00) and open globe injury (10.80; 2.54-45.92). Subgroup analysis showed higher SO risk among patients aged 18-39 years (5.70; 1.28-25.48) and 40-64 years (17.71; 2.36-132.60), in both males (12.96; 3.07-54.59) and females (9.10; 1.15-71.82), and among White patients (19.28; 2.58-144.00).

Our findings suggest that patients who have undergone ocular surgery with histories of ocular trauma should be closely monitored for the development of SO.