Prognostic factors in posterior open globe injuries (zone-III injuries).
OBJECTIVE
The aim of this study is to describe and identify clinical characteristics, prognostic factors and visual outcome in a group of patients with posterior open globe injuries (zone III injury).


METHODS
A retrospective review was made of all cases of open globe injuries that were examined at the Ophthalmology Department of Soroka Medical Center, Beer-Sheva, Israel, from 1995 to 2005. One hundred and eight consecutive patients diagnosed with open globe injuries were reviewed. Of these, 21 eyes from 21 patients with zone III injuries were analysed and are the subject of this study. We assessed the relationship of presenting visual acuity, cause and extent of injury, as well as the number of surgical procedures, postoperative complications with the final outcome.


RESULTS
The study group comprised 95% male subjects with a mean age of 35.8 years (range 20-60 years). The median follow up was 21.2 months (range 6-66 months). In 72.7% of the cases metal was the causative factor. Clinical signs associated with an adverse outcome included poor-presenting acuity, eyelid injury, cornea lamellar lacerations or abrasions, iris deformity, lens damage, ocular hypotony, coexisting injuries and a low ocular trauma score. No cases presented with post-traumatic endophthalmitis.


CONCLUSIONS
From this study we determined the most important prognostic factor in zone III open globe injuries is the presenting acuity. Other prognostic factors associated with a poor final outcome are eyelid injury, iris deformity, lens damage, ocular hypotonia, coexisting injuries and low ocular trauma score (< or =2). Posterior open eye injuries were most commonly owing to metal entering the eyes of young men.
Knyazer
Boris
B
Department of Ophthalmology, Soroka University Medical Center, Beer-Sheva, Israel. knyazer@bgu.ac.il
Levy
Jaime
J
Rosen
Shirley
S
Belfair
Nadav
N
Klemperer
Itamar
I
Lifshitz
Tova
T
D000328:Adult; D065306:Corneal Injuries; D005128:Eye Diseases / Q000453:epidemiology / Q000209:etiology; D015807:Eye Injuries, Penetrating / Q000150:complications / Q000601:surgery*; D005260:Female; D005547:Foreign Bodies / Q000601:surgery; D006801:Humans; D007908:Lens, Crystalline / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D014792:Visual Acuity; D055815:Young Adult