ABSTRACT
Aims: To describe the demographics, characteristics and outcomes of open-globe injuries (OGI) with respect to zone of injury. Methods: Medical records of all patients presenting with OGIs to University Hospital, Newark, NJ between January 2001 and December 2008 with a follow-up of at least 3 months were reviewed. Demographics, characteristics of the trauma and outcomes were compared with respect to the zone of injury; location of injury is confined to the cornea and limbus in zone 1 (Z1), <5 mm posterior to the limbus in zone 2 (Z2) and >5mm posterior to the limbus in zone 3 (Z3). Results: Of the 309 patients (310 eyes) identified, 228 (74%) were male. The mean age at presentation was 35.3 years (1-96). Mean follow-up was 22.8 months (3-108 months). Most of the eyes presented with Z1 injury: 141 eyes (46%) Z1 injury, 83 (27%) Z2 and 86 (28%) Z3. Rupture was the most common type of injury in Z2 and Z3 injuries. Nineteen (86%) of 22 eyes with an intraocular foreign body (IOFB) had a Z1 injury. 32 (42%) of 77 eyes with Z3 injury had no light perception (NLP) at presentation, compared with 9 (8%) of 119 Z1 and 13 (17%) of 78 Z2-injured eyes. Four percent of Z1, 11% of Z2 and 18% of Z3-injured eyes had a final vision (VA) of NLP. Primary enucleation was undertaken in 10 eyes (9 were Z2 injured eyes). Secondary enucleation was performed in 12 (9%) of 141 Z1, 7 of 82 (9%) of Z2 and 22 (26%) of 78 Z3 eyes. Thirty (36%) of 86 Z3 injuries resulted in primary or secondary enucleation. The final Snellen VA was 1.05, 1.41, and 2.19 respectively in Z1, Z2 and Z3-injured eyes. Posterior segment surgery was performed in 30% Z1, 39% Z2 and 49% Z3-injured eyes. Retinal detachment (RD) was diagnosed in 11% Z1, 27% Z2 and 40% Z3 injuries. Conclusion: Z1 injury may be associated with a better visual prognosis than Z2 and Z3 injuries. The visual prognosis of Z3 injured eyes is poor with one-third of these eyes being enucleated.
ABSTRACT
Aims: To characterize gender differences in the ophthalmic findings and clinical outcomes of patients with open globe (OG) injuries. Study Design: Retrospective case series. Place and Duration of Study: Department of Ophthalmology, University Hospital, New Jersey Medical School between January 2001 and June 2010. Methodology: The medical records of all patients presenting with OG injuries to University Hospital, Newark, NJ from January 1, 2001 through June 30, 2010 were reviewed. Demographics, characteristics of the trauma, ophthalmic findings, and outcomes were compared in male and female patients. Results: A total 603 eyes (602 patients) with OG injuries were identified. Most of the patients (76.4%) were male. The mean patient age was 39.14 years which was significantly lower in males (35.66 years vs. 50.43 years in females; p<0.001). The vast majority of injuries were penetrating and/or work-related in men, whereas fall-related ruptures comprised the most common pattern of injury in women. Zone I was the most commonly injured zone in both genders, and Zone III wounds were more commonly seen in males (p=0.03). Although females were more likely to present with a worse visual acuity (VA, p=0.005), the final VA was not significantly different between males and females (p=0.06), and a statistically significant improvement in vision occurred in both genders (p<0.001 in both). Fifteen percent of patients had an unfavorable anatomic outcome and underwent either primary or secondary enucleation; the rate was not different among males and females (17% in both). Conclusion: Male and female victims of OG injuries follow different trends in terms of demographics, etiology, and type of injury. This highlights the importance of applying different prevention strategies in the genders.