Clinical characteristics and prognostic factors of open globe injuries in a North Spain population: a 10-year review

• Published in: Eye (London) Vol. 37; no. 10; pp. 2101 - 2108
• Main Authors: Santamaría, Alaitz, Pérez, Silvia, De Luis, Beatriz, Orive, Ana, Feijóo, Raquel, Etxebarria, Jaime
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-07-2023; Nature Publishing Group
• Subjects: 692/308/174; 692/499; 692/700/1750; Acuity; Aged; Comorbidity; Environmental factors; Epidemiology; Eye Injuries - etiology; Eye Injuries, Penetrating - diagnosis; Eye Injuries, Penetrating - epidemiology; Eye Injuries, Penetrating - surgery; Humans; Injuries; Laboratory Medicine; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Patients; Perception; Pharmaceutical Sciences/Technology; Population studies; Prognosis; Prophylaxis; Regression analysis; Retina; Retrospective Studies; Rupture; Spain - epidemiology; Surgery; Surgical Oncology; Trauma; Trauma Severity Indices; Visual Acuity; Spain
• ISSN: 0950-222X; 1476-5454; 1476-5454
• DOI: 10.1038/s41433-022-02297-8

Objectives
To describe the epidemiologic and clinical characteristics of open globe injuries (OGIs) treated in a tertiary hospital and analyse predictors of visual outcome.
Methods
This retrospective observational study included all patients with OGIs admitted to Cruces University Hospital between 2010 and 2020. The descriptive analysis included demographic data, type of injury classified as “rupture”, “penetration”, “perforation”, or “intraocular foreign body”, trauma mechanism and setting, injury zone, Ocular Trauma Score, delay to surgery, length of hospital stay, antibiotic prophylaxis, initial and final best corrected visual acuity (BCVA), complications and further surgery. Univariate analysis and logistic regression were performed to identify prognostic factors, based on final BCVA.
Results
Overall, 207 OGI cases were reported. The most common type of injuries were ruptures caused by domestic falls. Notably, 44.4% of eyes developed phthisis bulbi. In the univariate analysis, the following variables were significantly linked to visual outcome: age > 60 years, “rupture”, “fall”, posterior and/or combined zones of injury, lens damage, retinal/choroidal detachment, initial BCVA of no light perception, and Ocular Trauma Score ≤ 2 (
p
 < 0.001). Delay to surgery, length of stay and further surgery did not have prognostic value. In the logistic regression, initial BCVA of no light perception (
p
 < 0.001) and injury zone III (
p
 = 0.005) remained significant predictors of poor outcome.
Conclusions
In the population studied, most OGIs were caused by domestic falls usually affecting elderly patients with comorbidities. Visual outcome depended on patients´ specific characteristics and the nature of the trauma itself, whereas environmental factors failed to show any prognostic value.