title: Characteristics of traumatic cataract wound dehiscence.
abstract: OBJECTIVE
  To characterize the clinical course of cataract wound dehiscence.
  
  
  METHODS
  Retrospective, comparative case series.
  
  
  METHODS
  Charts of open globe injuries (848 injuries in 846 patients) treated surgically at the Massachusetts Eye and Ear Infirmary between 2000 and 2009 were retrospectively reviewed. Time from original surgery to wound dehiscence, type of initial surgery, Ocular Trauma Score, age, gender, mechanism of injury, and visual acuity were analyzed.
  
  
  RESULTS
  Of 846 patients with 848 open globe injuries, 63 experienced cataract wound dehiscence. The majority of these cataract wounds (89%) were extracapsular cataract extraction (ECCE), with only 7 (11%) phacoemulsification wounds. The mean patient age in the wound rupture group was 78.2 years. Female patients comprised the majority (67%) of this subpopulation. The most common mechanisms of injury were fall (65%), blunt trauma (23%), and motor vehicle accident (7%). The median raw ocular trauma score was 47 in wound dehiscence patients. Visual acuity at presentation was light perception in the wound dehiscence group. The best postoperative visual acuity was significantly worse in the wound dehiscence group (hand motion) than in the remaining patients (20/40; P=.0002). When considering the phacoemulsification patients alone, these patients fared much better, with a median postoperative vision of 20/60.
  
  
  CONCLUSIONS
  Despite recent advances in cataract surgery, wound dehiscence remains a significant source of visual disability, mainly in the geriatric population. Rupture ECCE wound patients have a poor visual prognosis. Fortunately, patients with phacoemulsification site dehiscence appear to regain the majority of their vision after open globe repair.
authors.affiliation: Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02215, USA.
authors.forename: Carolyn E
authors.initials: CE
authors.lastname: Kloek
authors.forename: Michael T
authors.initials: MT
authors.lastname: Andreoli
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Andreoli
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D002648:Child; D002675:Child, Preschool; D015807:Eye Injuries, Penetrating / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012590:Sclera / Q000293:injuries*; D017678:Sex Distribution; D013529:Surgical Wound Dehiscence / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D015599:Trauma Severity Indices; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult