Visual outcome after emergency surgery for open globe eye injury in Japan

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Abstract

Background

Most patients with open globe eye injury are brought to hospital as emergency patients and usually require admission for emergency surgery. We analyzed the visual outcome in patients with open globe eye injury at our hospital over a 4-year period.

Patients and methods

This study reviewed 40 eyes of 40 patients with open globe eye injury who were presented to Juntendo University Shizuoka Hospital and required emergency surgery during the 4 years from January 2010 to December 2014. Retrospective evaluation of the visual outcome was performed using data from the medical records, including assessment of the influence of sex, side of the eye injury, cause of injury, and site/severity of injury.

Results

The mean age (SD) at the time of the injury was 58.9 years (±25.1 years). There were 28 males (70.0%) and 12 females (30.0%). Statistically significant improvement in visual acuity after treatment was noted in the males ( P=0.0015, Wilcoxon test), but not in the females. Twenty-five patients had injury to the right eye (62.5%) and 15 had injury to the left eye (37.5%). A significant improvement in visual acuity was achieved after treatment of injury to the right eye ( P=0.021), but not the left eye ( P=0.109). The most frequent cause of injury was an accident (15 eyes; 37.5%). The second most frequent cause was work-related injury (14 eyes; 35.0%), which only occurred in males, and the third cause was accident due to negligence (eleven eyes; 27.5%). Two patients developed sympathetic ophthalmia and one patient developed postoperative endophthalmitis.

Conclusion

The majority of patients with open globe eye injury were male workers in Japan. The visual outcome of work-related injury was better than that of injury due to other causes. The visual outcome was also better if the right eye was injured compared with the left eye. Patients with injuries due to negligence were older than the other groups, and this finding might be characteristic of an aging society.

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Most cited references 17

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A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group.

José A. Cardillo, Ian T Meredith, P Sternberg … (1997)

To develop a classification system for mechanical injuries of the eye. The Ocular Trauma Classification Group, a committee of 13 ophthalmologists from seven separate institutions, was organized to discuss the standardization of ocular trauma classification. To develop the classification system, the group reviewed trauma classification systems in ophthalmology and general medicine and, in detail, reports on the characteristics and outcomes of eye trauma, then established a classification system based on standard terminology and features of eye injuries at initial examination that have demonstrated prognostic significance. This system classifies both open-globe and closed-globe injuries according to four separate variables: type of injury, based on the mechanism of injury; grade of injury, defined by visual acuity in the injured eye at initial examination; pupil, defined as the presence or absence of a relative afferent pupillary defect in the injured eye; and zone of injury, based on the anteroposterior extent of the injury. This system is designed to be used by ophthalmologists and nonophthalmologists who care for patients or conduct research on ocular injuries. An ocular injury is classified during the initial examination or at the time of the primary surgical intervention and does not require extraordinary testing. This classification system will categorize ocular injuries at the time of initial examination. It is designed to promote the use of standard terminology and assessment, with applications to clinical management and research stud ies regarding eye injuries.

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Enucleation for open globe injury.

Christopher Andreoli, Aaron Savar, Michael T Andreoli … (2009)

To report the experience of enucleation after open globe at an ophthalmic trauma referral center. Retrospective, observational study. In an ophthalmic trauma referral center the charts of all patients having suffered an open globe injury between January 1, 2000 and June 30, 2007 were reviewed. Variables assessed were age, gender, type of injury (rupture or laceration [penetrating, intraocular foreign body, or perforating]), ocular trauma score, visual acuity, subsequent enucleation, indication for and timing of enucleation, presence of sympathetic ophthalmia, and length of follow-up. Among 660 open globe injuries, 55 have undergone enucleation (including 4 eviscerations), 11 primarily and 44 secondarily. Eyes with ruptures were significantly more likely to be enucleated than those with injuries attributable to lacerations (P < .001). The most common reason for secondary enucleation was a blind, painful eye. Two patients (0.3%) developed sympathetic ophthalmia and have maintained good vision in the sympathizing eye. The vast majority of open globes can be repaired without requiring primary enucleation. Secondary enucleation is most commonly carried out for pain. Eyes with no light perception can be closely observed if the patient chooses.

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Characteristics and outcomes of work-related open globe injuries.

Justin Kanoff, Angela V Turalba, Michael T Andreoli … (2010)

To evaluate the characteristics and outcomes of patients treated for open globe injuries sustained at work and to compare these results to patients injured outside of work. Retrospective chart review of 812 consecutive patients with open globe injuries treated at the Massachusetts Eye and Ear Infirmary between 1999 and 2008. A total of 146 patients with open globe injuries sustained at work were identified and their characteristics and outcomes were compared with the rest of the patients in the database. Of the patients injured at work, 98% were men, and the average age of the patients was 35.8 years (17-72 years). The most common mechanism of injury was penetrating trauma (56%); 38 patients examined had intraocular foreign bodies (IOFB). Nine work-related open globe injuries resulted in enucleation. There was a higher incidence of IOFBs (P = .0001) and penetrating injuries (P = .0005) in patients injured at work. Both the preoperative (P = .0001) and final best-corrected visual acuity (P = .0001) was better in the work-related group. The final visual acuity was better than 20/200 in 74.1% of cases of work-related open globe injuries. However, there was no difference observed in the rate of enucleations (P = .4). Work-related injuries can cause significant morbidity in a young population of patients. Based on average patient follow-up and final visual acuity, those injured at work do at least as well as, if not potentially better than, those with open globe injuries sustained outside of work. While the statistically higher rate of IOFB in the work population is not surprising, it does emphasize the importance of strict adherence to the use of eye protection in the workplace. Copyright (c) 2010 Elsevier Inc. All rights reserved.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Ophthalmol

Journal ID (iso-abbrev): Clin Ophthalmol

Journal ID (publisher-id): Clinical Ophthalmology

Title: Clinical Ophthalmology (Auckland, N.Z.)

Publisher: Dove Medical Press

ISSN (Print): 1177-5467

ISSN (Electronic): 1177-5483

Publication date Collection: 2016

Publication date (Electronic): 08 September 2016

Volume: 10

Pages: 1731-1736

Affiliations

[1 ]Department of Ophthalmology, Juntendo University Shizuoka Hospital, Shizuoka

[2 ]Department of Ophthalmology, Juntendo University Nerima Hospital

[3 ]Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan

Author notes

Correspondence: Hiroshi Toshida, Department of Ophthalmology, Juntendo University Shizuoka Hospital, 1129 Izunokuni, Shizuoka 410-2295, Japan, Tel +81 55 948 3111, Fax +81 55 948 3351, Email toshida@ 123456juntendo.ac.jp

Article

Publisher ID: opth-10-1731

DOI: 10.2147/OPTH.S103704

PMC ID: 5019441

PubMed ID: 27660410

SO-VID: d9962cc7-b952-434f-a968-7a69293c960a

License:

The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Visual outcome after emergency surgery for open globe eye injury in Japan

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Abstract

Background

Patients and methods

Results

Conclusion

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Clinical Virtual Research Center Journal of Ophthalmology

Most cited references 17

A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group.

Enucleation for open globe injury.

Characteristics and outcomes of work-related open globe injuries.

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