Abstract
Background: To identify prognostic factors for visual acuity and anatomic outcomes after repair of open globe injuries.
Methods: We retrospectively reviewed the medical records of 443 patients with open globe injuries admitted to King Abdulaziz University Hospital between May 1996 and January 2008.
Results: Predictors of good visual outcome (20/200 or better) were age of 18 years or younger, good initial visual acuity of counting fingers or better, sharp mechanism of injury, wound length of 10 mm or less, wounds limited to the cornea, absence of associated ocular injuries at presentation including lens injury, vitreous hemorrhage, vitreous prolapse and retinal detachment, absence of endophthalmitis, vitrectomy not performed, and findings at final evaluation including clear vitreous, attached retina, and absence of hypotony. Predictors of persistent retinal detachment at final evaluation were poor initial visual acuity of hand motions or worse, posterior wound location, and performance of vitrectomy. Predictors of hypotony at final evaluation were poor initial visual acuity of hand motions or worse, dirty wound, presence of vitreous hemorrhage, and vitreous prolapse at presentation, development of culture-positive endophthalmitis, performance of vitrectomy, and persistent retinal detachment at final follow-up.
Conclusions: Prognosis after repair of an open globe injury is influenced by age, initial visual acuity, mechanism of injury, location and extent of initial damage, and development of endophthalmitis.