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Characteristics and outcomes of fall-related open-globe injuries in pseudophakic patients.

Kavoussi SC, Slade MD, Meskin SW, Adelman RA - Clin Ophthalmol (2015)

Bottom Line: OTS was lower (P=0.0017, P<0.0001, and P=0.0240) and wound size was larger (P=0.0440, 0.0145, and 0.0026) in patients with final BCVA <20/40, <20/400, and phthisis at final follow-up, respectively; compared to patients with BCVA ≥20/40, 20/400, and no phthisis at final follow-up, respectively.Final BCVA <20/400 was associated with 360° subconjunctival hemorrhage (SCH), retinal detachment, and proliferative vitreoretinopathy (P=0.0498, 0.0181, and 0.0310, respectively).Ophthalmologists dealing primarily with geriatric populations should contribute to the discussion of fall risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA.

ABSTRACT

Aim: We aimed to identify the characteristics and prognostic indicators of poor visual and anatomic outcome in pseudophakic patients with fall-related open-globe (OG) injuries. We used a case series design, for a total of 26 patients.

Methods: Charts of consecutive pseudophakic patients with fall-related OG injury at a single institution were reviewed. Demographics, ophthalmic history, circumstances of injury, initial best-corrected visual acuity (BCVA), examination findings, surgical interventions, and follow-up BCVA were tabulated for statistical analysis with unpaired t-tests and Fisher's exact tests.

Results: Nineteen patients (73%) were women. Mean (± standard deviation) age was 80.6±4.6 years (range: 61-97 years). Initial BCVA was <20/400 in 24 of 25 patients (96%). Mean ocular trauma score (OTS) was 38.54±10.95. OTS was lower (P=0.0017, P<0.0001, and P=0.0240) and wound size was larger (P=0.0440, 0.0145, and 0.0026) in patients with final BCVA <20/40, <20/400, and phthisis at final follow-up, respectively; compared to patients with BCVA ≥20/40, 20/400, and no phthisis at final follow-up, respectively. Final BCVA <20/400 was associated with 360° subconjunctival hemorrhage (SCH), retinal detachment, and proliferative vitreoretinopathy (P=0.0498, 0.0181, and 0.0310, respectively). Total hyphema, intraocular lens (IOL) damage, and IOL expulsion were associated with needing multiple surgical interventions (P=0.0345, P<0.0001, and P=0.0023, respectively).

Conclusion: Large wound size, low OTS, 360° SCH, total hyphema, posterior injury, and IOL damage are common findings that are also prognostic of poor visual and anatomic outcome in pseudophakic patients with fall-related OG injuries. Ophthalmologists dealing primarily with geriatric populations should contribute to the discussion of fall risk.

No MeSH data available.


Related in: MedlinePlus

Wound size (mm) at the time of injury.Abbreviations: BCVA, best-corrected visual acuity; ECCE, extracapsular cataract extraction; PE, phacoemulsification; PKP, penetrating keratoplasty.
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f2-opth-9-403: Wound size (mm) at the time of injury.Abbreviations: BCVA, best-corrected visual acuity; ECCE, extracapsular cataract extraction; PE, phacoemulsification; PKP, penetrating keratoplasty.

Mentions: Mean OTS was 38.54±10.95. OTS was significantly lower in patients with 6-month and final BCVA <20/40, <20/400, and phthisis, compared to patients with BCVA ≥20/40, 20/400, and no phthisis, respectively (P=0.0017, P<0.0001, and P=0.0240; Table 2 and Figure 1). Wound size was significantly larger in the same categories (P=0.0440, 0.0145, and 0.0026; Table 3 and Figure 2). There was no significant difference in OTS or wound size between patients with history of ECCE versus standard PE or between those with PKP versus no PKP. Times to presentation and primary repair were within 24 hours for 24 of 26 patients.


Characteristics and outcomes of fall-related open-globe injuries in pseudophakic patients.

Kavoussi SC, Slade MD, Meskin SW, Adelman RA - Clin Ophthalmol (2015)

Wound size (mm) at the time of injury.Abbreviations: BCVA, best-corrected visual acuity; ECCE, extracapsular cataract extraction; PE, phacoemulsification; PKP, penetrating keratoplasty.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356447&req=5

f2-opth-9-403: Wound size (mm) at the time of injury.Abbreviations: BCVA, best-corrected visual acuity; ECCE, extracapsular cataract extraction; PE, phacoemulsification; PKP, penetrating keratoplasty.
Mentions: Mean OTS was 38.54±10.95. OTS was significantly lower in patients with 6-month and final BCVA <20/40, <20/400, and phthisis, compared to patients with BCVA ≥20/40, 20/400, and no phthisis, respectively (P=0.0017, P<0.0001, and P=0.0240; Table 2 and Figure 1). Wound size was significantly larger in the same categories (P=0.0440, 0.0145, and 0.0026; Table 3 and Figure 2). There was no significant difference in OTS or wound size between patients with history of ECCE versus standard PE or between those with PKP versus no PKP. Times to presentation and primary repair were within 24 hours for 24 of 26 patients.

Bottom Line: OTS was lower (P=0.0017, P<0.0001, and P=0.0240) and wound size was larger (P=0.0440, 0.0145, and 0.0026) in patients with final BCVA <20/40, <20/400, and phthisis at final follow-up, respectively; compared to patients with BCVA ≥20/40, 20/400, and no phthisis at final follow-up, respectively.Final BCVA <20/400 was associated with 360° subconjunctival hemorrhage (SCH), retinal detachment, and proliferative vitreoretinopathy (P=0.0498, 0.0181, and 0.0310, respectively).Ophthalmologists dealing primarily with geriatric populations should contribute to the discussion of fall risk.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology and Visual Science, Yale University School of Medicine, New Haven, CT, USA.

ABSTRACT

Aim: We aimed to identify the characteristics and prognostic indicators of poor visual and anatomic outcome in pseudophakic patients with fall-related open-globe (OG) injuries. We used a case series design, for a total of 26 patients.

Methods: Charts of consecutive pseudophakic patients with fall-related OG injury at a single institution were reviewed. Demographics, ophthalmic history, circumstances of injury, initial best-corrected visual acuity (BCVA), examination findings, surgical interventions, and follow-up BCVA were tabulated for statistical analysis with unpaired t-tests and Fisher's exact tests.

Results: Nineteen patients (73%) were women. Mean (± standard deviation) age was 80.6±4.6 years (range: 61-97 years). Initial BCVA was <20/400 in 24 of 25 patients (96%). Mean ocular trauma score (OTS) was 38.54±10.95. OTS was lower (P=0.0017, P<0.0001, and P=0.0240) and wound size was larger (P=0.0440, 0.0145, and 0.0026) in patients with final BCVA <20/40, <20/400, and phthisis at final follow-up, respectively; compared to patients with BCVA ≥20/40, 20/400, and no phthisis at final follow-up, respectively. Final BCVA <20/400 was associated with 360° subconjunctival hemorrhage (SCH), retinal detachment, and proliferative vitreoretinopathy (P=0.0498, 0.0181, and 0.0310, respectively). Total hyphema, intraocular lens (IOL) damage, and IOL expulsion were associated with needing multiple surgical interventions (P=0.0345, P<0.0001, and P=0.0023, respectively).

Conclusion: Large wound size, low OTS, 360° SCH, total hyphema, posterior injury, and IOL damage are common findings that are also prognostic of poor visual and anatomic outcome in pseudophakic patients with fall-related OG injuries. Ophthalmologists dealing primarily with geriatric populations should contribute to the discussion of fall risk.

No MeSH data available.


Related in: MedlinePlus