Open Globe Injuries: Classifications and Prognostic Factors for Functional Outcome

This paper explored epidemiology and evaluation of posterior segment involvement as prognostic factors for functional outcome of patients with open globe injuries. A retrospective analysis of 151 patients with open globe injuries was conducted. Pre- and postoperative-corrected distance visual acuity (CDVA), epidemiologic data, classification of the injuries including the ocular trauma score (OTS), performed surgeries, intraocular pressure (IOP) and correlation analyses between OTS and postoperative CDVA were obtained. A total of 147 eyes were included in the study. Mean age was 42.9 ± 22.2 years, 78.2% were male, and 36.7% of injuries occurred in the workplace. Thirty-eight patients (25.9%) had intraocular foreign bodies. Concerning injury location, 51.7% of the injuries were located in zone I (cornea, corneoscleral limbus), 15.0% in zone II (up to 5 mm posterior the sclerocorneal limbus) and 32.0% in zone III (posterior of zone 2). Affected structures were eyelids (17.7%), cornea (74.8%), iris (63.9%), lens (56.5%), sclera (48.3%), retina (47.6%) and optic nerve (19.7%). Mean preoperative CDVA was 1.304 ± 0.794 logMAR and 1.289 ± 0.729 logMAR postoperatively (p = 0.780). Patients with posterior segment involvement had significantly worse postoperative CDVA than patients without (1.523 ± 0.654 logMAR vs. 0.944 ± 0.708 logMAR, p < 0.01). Predictive factors for good visual outcome of open globe injuries are good initial CDVA and ocular trauma affecting only zone I and II.