Prognostic Indicators for No Light Perception After Open-Globe Injury: Eye Injury Vitrectomy Study

• Published in: American journal of ophthalmology Vol. 152; no. 4; pp. 654 - 662.e2
• Main Authors: Feng, Kang, Hu, Yun Tao, Ma, Zhizhong
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2011; Elsevier; Elsevier Limited
• Subjects: Adult; Biological and medical sciences; Blindness - diagnosis; Blindness - surgery; Child; Choroid - injuries; Choroid Hemorrhage - diagnosis; Ciliary Body - injuries; Diabetic retinopathy; Epidemiology; Evidence-based medicine; Eye Enucleation; Eye Injuries, Penetrating - diagnosis; Eye Injuries, Penetrating - surgery; Eye protection; Eye surgery; Eyes & eyesight; Hemorrhage; Hospitals; Humans; Injuries of the orbit. Foreign bodies of the eye. Diseases due to physical agents; Light; Medical sciences; Middle Aged; Miscellaneous; Multivariate analysis; Ophthalmology; Prognosis; Prolapse; Prospective Studies; Retina - injuries; Risk Factors; Sclera - injuries; Surgery; Traumas. Diseases due to physical agents; Variables; Visual Acuity - physiology; Vitrectomy; Young Adult; China; Eye disease; Prognosis; Treatment; Surgery; Light; Eye injury; Perception; Vitrectomy; Lesion; Ophthalmology; Eye trauma
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2011.04.004

Purpose To describe ocular characteristics, surgical interventions, and anatomic and visual outcomes of traumatized eyes with no light perception (NLP) following open-globe injury and to investigate prognostic predictors for NLP cases after open-globe injury. Design Interventional case series study. Methods Thirty-three traumatized eyes with NLP were selected from the Eye Injury Vitrectomy Study database, a hospital-based multicenter prospective cohort study. Inclusion criteria were NLP cases following open-globe injury with outcomes of anatomic restoration, phthisis bulbi, or enucleation. Exclusion criteria were cases with missing records, undergoing vitrectomy after injury at nonparticipating hospitals, direct optic head injury, endophthalmitis, and hypotonous or silicone oil–sustained eyes. All cases underwent vitreoretinal surgery or enucleation after exploratory surgery and were followed up for at least 6 months. Two outcomes were assessed: favorable outcome (anatomically restored eye globes with light perception [LP] or better vision) and unfavorable outcome (NLP, phthisis bulbi, or enucleation). Results The following 7 risk factors were significant between the 2 groups: rupture ( P = .021); open globe III ( P = .046); scleral wound ≥10 mm ( P = .001); ciliary body damage ( P < .001); severe intraocular hemorrhage ( P = .005); closed funnel retinal detachment or retinal prolapse ( P = .005); and choroidal damage ( P = .001). Conclusions These 7 risk factors are possible predictors of poor prognosis. Traumatized eyes with NLP can be anatomically restored with LP or better vision if vitreoretinal surgery is attempted, and a favorable anatomic and visual outcome is increased by having a decreased number of these risk factors.