Prognostic factors for vision outcome after surgical repair of open globe injuries.

Purpose: To evaluate the factors influencing final visual outcome after surgical repair of open globe injuries. Materials and Methods: The study was carried out at a tertiary referral eye care center in Central India. In this retrospective study, case records of 669 patients with open globe injuries were analyzed. Different preoperative variables were correlated with the final visual outcome. Exclusion criteria were patients with less than four months follow up, previous ocular surgery, presence of intraocular foreign body or endophthalmitis at the time of presentation. Using statistical tests, the prognostic factors for vision outcome following surgical repair of open globe injuries were studied. Results: Based on the Spearman's Rho correlation analysis, following factors were found to be significantly associated with the final visual acuity at univariate level: age (P<0.001), preoperative visual acuity (P=0.045), mode of injury (P=0.001), and time lag between the injury and surgery (P=0.003). None of the other clinical factors have statistically significant correlation with final visual acuity. On multivariate analysis using binary logistic regression, only age, mode of injury and the time lag between injury and surgery achieved statistically significant results. Conclusion: In the current study, elapsed time between the injury and surgery, age of the patient, preoperative visual acuity and mode of injury were found to be adversely affecting the final visual outcome. Recognizing these factors prior to surgical intervention or intraoperatively can help the surgeon in evidence-based counseling of the trauma victim and family.

Factors Affecting the Visual Outcome after Successful Retinal Reattachment Surgery in Rhegmatogenous Retinal Detachment Involving the Macula

To investigate the factors affecting the visual outcome after otherwise successful retinal reattachment surgery in rhegmatogenous retinal detachment involving macula, we performed a retrospective surgvey on 170 eyes encountered properly for this study. Preoperative variables used in this series included age of patients, duration of macular detachment, preoperative visual acuity, extent of detached retina, distance between breaks, and number, shape and location of breaks. We achieved visual acuities of 20/50 or better in 49% (83 of 170 eyes) after retinal reattachment surgery. Factors related to the favorable visual outcome (20/50 or better) were macular detachment lasting less than one month, preoperative visual acuities of 20/200 or better, extent of retinal detachment of 3Q or less, and detachment with tears located at or anterior to the equator. There was no relationship between the visual outcome and the type and the number of the breaks. Of all these variables, preoperative visual acuity has the closest correlation with the final visual results after anatomically successful reattachment surgery.