Fourteen-Year Review of Open Globe Injuries in an Urban Korean Population

Abstract

OBJECTIVE: To review the epidemiology and prognostic factors related to visual outcome after open globe injuries. METHODS: A retrospective case review during a 14-year period. RESULTS: The study was based on a sample of 321 patients (321 eyes) with open globe injuries. Gender of the sample was predominantly male (76.6%) and the average age was 38.8 years. Injuries occurred most frequently in autumn (37.7%) and in the work place (45.8%). The anatomic site of the wound was corneal (zone I) in 148 eyes, corneoscleral (zone II) in 61 eyes, and scleral (zone III) in 92 eyes. Initial visual acuity was 4/200 or worse in 77.9% of patients and was significantly correlated with the zone of injury (linear by linear association p = 0.000). The elapsed time from injury to surgery was shorter than 48 hours in 90.7%. Primary repair was performed in 301 eyes and, subsequently, pars plana vitrectomy in 165 eyes, and cataract extraction in 67 eyes. Anatomic success was achieved in 91% of eyes and evisceration was performed in 7.8% (25 eyes). Final visual acuity of 5/200 or better was achieved in 58.3% of patients, and vision of 20/40 or better in 36.5%. The zone of injury was the most significant predictor of functional outcome (linear by linear association p = 0.000) as well as anatomic outcome (chi p = 0.000). Associated injuries such as retinal detachment, vitreous hemorrhage, uveal prolapse, and adnexal injury were also important prognostic factors (linear by linear association, p = 0.000). CONCLUSIONS: In this study, we identified the epidemiology and prognostic factors of open globe injuries in a Korean urban community. The visual as well as anatomic outcome for open globe injury was shown to be reasonably favorable when prompt and appropriate surgical management was applied.