Risk Factors and Clinical Manifestations of Ocular Hypertension after Primary Repair of Open Globe Injury

ABSTRACT

PURPOSE: To investigate the risk factors and clinical manifestations of ocular hypertension (HTN) after repair of open globe injury (OGI). METHODS: In a retrospective study of 284 patients who underwent primary repair of open globe injury at the day of trauma, best corrected visual acuity (BCVA) at the time of trauma and 6 months postoperatively, length of laceration, location of laceration and mean intraocular pressure (IOP) at 1 month after primary repair were analyzed. Presence of iris injury, lens injury, intraocular foreign body (IOFB) and vitreous hemorrhage (VH) were also analyzed. Ocular hypertension was defined as elevation of IOP greater than or equal to 21 mm Hg over 3 measurements. RESULTS: Fourteen (4.93%) of 284 patients had ocular hypertension. BCVA (log MAR) at the time of trauma in the ocular HTN group was significantly worse than in the normal IOP group (2.43 +/- 1.04 and 1.76 +/- 1.30, respectively, p = 0.033). In the multivariate analysis, ocular HTN increased significantly with IOFB (p = 0.038; odds ratio [OR], 3.584; 95% confidence interval [CI], 1.075-11.941) and VH (p = 0.028; OR, 3.971; 95% CI, 1.157-13.624). BCVA increased significantly after repair in both groups and mean IOP was well controlled after medical therapy (9 eyes) or surgical treatment (5 eyes) in the ocular HTN group (28.1 +/- 4.7 and 15.8 +/- 3.8, respectively, p < 0.01). CONCLUSIONS: Ocular HTN increased significantly with IOFB and VH at the time of trauma after repair of OGI and can be effectively treated by medication or surgical approach.