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2012, Number 3

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Cir Cir 2012; 80 (3)

Can visual outcome be improved in open globe ocular trauma?

Lima-Gómez V, Ponce de León-Ascencio C, Razo Blanco-Hernández DM

Language: Spanish
References: 22
Page: 211-217
PDF size: 397.51 Kb.


ABSTRACT

Background: Visual prognosis of injured eyes estimated by the Ocular Trauma Score (OTS) can be used to evaluate the efficacy of open globe treatment. The aim of this study was to identify the OTS features over which interventions could be performed to improve visual outcome in patients with open globe trauma.
Methods: We carried out an observational, longitudinal, retrospective– prospective, analytical study. Patients with open globe trauma from a general hospital were evaluated. The initial proportions of visual deficiency (best corrected visual acuity ‹20/40) and ambulatory vision (best corrected visual acuity ›20/200) were identified, and the corresponding expected proportions and 95% confidence intervals (CI) after treatment were estimated using the OTS; both proportions were compared with those obtained in the sample (χ2). OTS features associated with a higher proportion of visual improvement were identified.
Results: Fifty eyes were studied (mean age 28.6 ± 19 years, 58.4% males). The initial proportion of visual deficiency changed from 92% to 72% (p = 0.009) and that of ambulatory vision changed from 24% to 52% (p = 0.004); the expected proportion of visual deficiency was 58% (95% C.I. 44–72) and that of ambulatory vision was 64% (95% CI 52–77). In eyes with OTS category 3 where neither ruptures nor surgical retinal diseases were initially found, visual improvement was more common but less than expected.
Conclusions: Treatment significantly changed the proportions of visual deficiency and ambulatory vision, but its efficacy was the minimal expected. Standardization of anterior segment surgical procedures may improve visual outcome in eyes with open globe trauma with OTS categories 3 to 5.


REFERENCES

  1. Bailey RN, Indian RW, Zhang X, Geiss LS, Duenas MR, Saaddine JB. Visual impairment and eye care among older adults - five States, 2005. Morb Mortal Wkly Rep 2006;55:1321-1325.

  2. Pieramici DJ, Sternberg P Jr, Aaberg TM, Bridges WZ, Capone A Jr, Cardillo JA, et al. A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group. Am J Ophthalmol 1997;123:820-831.

  3. Salehi-Had H, Andreoli CM, Andreoli MT, Kloek C, Mukai S. Visual outcomes of vitreoretinal surgery in eyes with severe open-globe injury presenting with no-light perception vision. Graefes Arch Exp Ophthalmol 2009;247:477-483.

  4. Heidari E, Taheri N. Surgical treatment of severely traumatized eyes with no light perception. Retina 2010;30:294-299.

  5. Kuhn F, Maisiak R, Mann L, Mester V, Morris R, Witherspoon CD. The Ocular Trauma Score (OTS). Ophthalmol Clin North Am 2002;15:163-165.

  6. Unal MH, Aydin A, Sonmez M, Ayata A, Ersanli D. Validation of the ocular trauma score for intraocular foreign bodies in deadly weapon-related open-globe injuries. Ophthalmic Surg Lasers Imaging 2008;39:121-124.

  7. Unver YB, Acar N, Kapran Z, Altan T. Visual predictive value of the ocular trauma score in children. Br J Ophthalmol 2008;92:1122-1124.

  8. Uysal Y, Mutlu FM, Sobac G. Ocular trauma score in childhood open-globe injuries. J Trauma 2008;65:1284-1286.

  9. Lima-Gómez V, Razo Blanco-Hernández DM. Efecto esperado del tratamiento del trauma ocular sobre la proporción inicial de deficiencia visual. Cir Cir 2010;78:302-309.

  10. Urrutia MM, Ramírez EJA, Levine BA. Evaluación de la escala de severidad en trauma ocular abierto. Rev Mex Oftalmol 2007;81:264-266.

  11. Peña-Aceves A, Pérez-Reguera A, Hernández-Fernández F, Suárez- Tatá L, Quiróz-Mercado H. Epidemiología de heridas corneoesclerales en un hospital de especialidad. Rev Mex Oftalmol 2006;80:333–339.

  12. Cakmak SS, Unlu MK, Olmez G, Caca I, Sakalar YB, Acemoglu H. Penetrating eye injuries from southeastern Anatolia region of Turkey. Public Health 2004;118:570-575.

  13. Purkayastha S, Sharma G. A retrospective analysis of open globe injuries in a tertiary ophthalmological centre in North-East India. Kathmandu Univ Med J 2005;3:255-288.

  14. Bhogal G, Tomlins PJ, Murray PI. Penetrating ocular injuries in the home. J Public Health 2007;29:72-74.

  15. Mansouri M, Faghihi H, Hajizadeh F, Rasoulinejad SA, Rajabi MT, Tabatabaey A, et al. Epidemiology of open-globe injuries in Iran. Analysis of 2,340 cases in 5 years (Report No. 1). Retina 2009;29:1141-1149.

  16. Larque-Daza AB, Peralta-Calvo J, Lopez-Andrade J. Epidemiology of open-globe trauma in the southeast of Spain. Eur J Ophthalmol 2010;20:578-583.

  17. Kanoff JM, Turalba AV, Andreoli MT, Andreoli CM. Characteristics and outcomes of work-related open globe injuries. Am J Ophthalmol 2010;150:265-269.

  18. Weyll M, Silveira RC, Lopes da Fonseca N. Trauma ocular aberto: características de casos atendidos no complexo Hospital Padre Bento de Guarulhos. Arq Bras Oftalmol 2005;68:505-510.

  19. Al-Mezaine HS, Osman EA, Kangave D, Abu El-Asrar AM. Prognostic factors after repair of open globe injuries. J Trauma 2010;69:943-947.

  20. Lee HS, Ahn JK. Emergent risk factors associated with eyeball loss and ambulatory vision loss after globe injuries. J Trauma 2010;69:195-198.

  21. Kuhn F. Ocular traumatology: prevention, prevention, prevention… Graefes Arch Clin Exp Ophthalmol 2010;248:299-300.

  22. Kuhn F, Slezakb Z. Damage control surgery in ocular traumatology. Injury 2004;35:690-696.




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